Provider Demographics
NPI:1902858665
Name:ZAFAR, SUBOOHA (MD)
Entity Type:Individual
Prefix:
First Name:SUBOOHA
Middle Name:
Last Name:ZAFAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 WHITEHORSE MERCERVILLE RD STE 219
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3835
Mailing Address - Country:US
Mailing Address - Phone:609-815-7797
Mailing Address - Fax:609-584-5144
Practice Address - Street 1:1401 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3835
Practice Address - Country:US
Practice Address - Phone:609-584-5150
Practice Address - Fax:609-584-5144
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204235207RC0200X, 207RP1001X, 207RS0012X
NJ25MA06774300207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0264369Medicaid
NY2472439Medicaid
NY7V4751Medicare PIN
NYH90515Medicare UPIN