Provider Demographics
NPI:1902809742
Name:QADIR, ABDUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ABDUL
Middle Name:
Last Name:QADIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ABDUL
Other - Middle Name:
Other - Last Name:QADIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1004 S NEW RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-3730
Mailing Address - Country:US
Mailing Address - Phone:609-652-4141
Mailing Address - Fax:609-652-9939
Practice Address - Street 1:1004 S NEW RD
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-3730
Practice Address - Country:US
Practice Address - Phone:609-652-4141
Practice Address - Fax:609-652-9939
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA64342174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7313101Medicaid
G55529Medicare UPIN
NJ7313101Medicaid