Provider Demographics
NPI:1144264508
Name:ZANJANIAN, MOHAMAD H (MD)
Entity type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:H
Last Name:ZANJANIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AMIR
Other - Middle Name:MH
Other - Last Name:ZANJANIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:930 CLIFTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2723
Mailing Address - Country:US
Mailing Address - Phone:973-471-9191
Mailing Address - Fax:973-470-9858
Practice Address - Street 1:930 CLIFTON AVENUE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2723
Practice Address - Country:US
Practice Address - Phone:973-471-9191
Practice Address - Fax:973-470-9858
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27180207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C61147Medicare UPIN
166559Medicare ID - Type Unspecified
NJC61147Medicare UPIN