Individual
MUMTAZ AHMAD NIAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 BERGEN ST # D-1650, NEWARK, NJ 07103
(973) 972-9000
(973) 972-8325
Mailing address
30 BERGEN ST RM 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA07924400
NJ
207RI0008X
Hepatology Physician
Primary
25MA07924400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232664784
TAXID
PA
05
—
60063701
—
SD
Enumeration date
07/19/2006
Last updated
02/22/2022
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