Individual
MRS. DIANE M. MUSTAFA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
916 MAIN AVE STE 2C, PASSAIC, NJ 07055-8545
(973) 200-2794
(973) 777-9405
Mailing address
916 MAIN AVE STE 2C, PASSAIC, NJ 07055-8545
(973) 200-2794
(973) 777-9405
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
25MA09377500
NJ
207VG0400X
Gynecology Physician
Primary
25MA09377500
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/24/2011
Last updated
03/12/2020
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