Individual
FATIMA A MASUMOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
15 PADDOCK ST, AVENEL, NJ 07001-1856
(732) 499-5041
Mailing address
323 WINDSOR RD, MULLICA HILL, NJ 08062-1875
(908) 907-6747
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
OS021046
PA
2084P0800X
Psychiatry Physician
OS021046
PA
2084P0804X
Child & Adolescent Psychiatry Physician
OS021046
PA
Other
Enumeration date
04/09/2013
Last updated
02/08/2022
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