Individual
MARIAM WALLIZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2440 HAMBURG TPKE, WAYNE, NJ 07470-6226
(866) 389-2727
Mailing address
2440 HAMBURG TPKE, WAYNE, NJ 07470-6226
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00978800
NJ
Other
Enumeration date
12/16/2019
Last updated
07/27/2024
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