Individual
MR. NIDAL MATALKAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 HAMBURG TPKE, SUITE 107, WAYNE, NJ 07470-2154
(973) 595-7456
(973) 904-9119
Mailing address
PO BOX 2336, WAYNE, NJ 07470
(973) 595-7456
(973) 904-9119
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MA061937
NJ
207RP1001X
Pulmonary Disease Physician
Primary
MA061937
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6826407
—
NJ
Enumeration date
10/30/2006
Last updated
08/06/2010
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