Provider Demographics
NPI:1730227703
Name:CHEEMA, HUMAYUN MAHMOOD (MD)
Entity type:Individual
Prefix:
First Name:HUMAYUN
Middle Name:MAHMOOD
Last Name:CHEEMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 OLD SHORT HILLS ROAD
Mailing Address - Street 2:SUITE 1172
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4043
Mailing Address - Country:US
Mailing Address - Phone:973-322-5195
Mailing Address - Fax:973-322-2471
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:SUITE 1172
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5195
Practice Address - Fax:973-322-2471
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0261174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF00929OtherHEALTHNET
NJ0674718OtherCIGNA
NJ1055057OtherHORIZON NJ HEALTH
NJ3004805Medicaid
NJ4094186OtherAETNA INSURANCE COMPANY
NJ222014044OtherHORIZON BLUE CROSS
NJ28661OtherEMPIRE BC BS
NJD01297OtherOXFORD
NJ0674718OtherCIGNA
NJ1055057OtherHORIZON NJ HEALTH
NJD13348Medicare UPIN