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Individual

DR. HUMZALA ALI BASHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MBBS

Contact information

Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-7425
Mailing address
7535 197TH ST, FRESH MEADOWS, NY 11366-1816

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
03/21/2024
Last updated
03/21/2024
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