Basic Information
| Provider Information | |||||||||
| NPI: | 1831265826 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | GHAZI | ||||||||
| FirstName: | MOHAMMAD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 STEWART PL | ||||||||
| Address2: | APT C | ||||||||
| City: | FAIR LAWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2017942264 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 CENTRAL AVENUE GREYS | ||||||||
| Address2: | GREYSTONE PARK PSYCHIATRIC HOSPITAL | ||||||||
| City: | GREYSTONE PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9735381800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2006 | ||||||||
| LastUpdateDate: | 12/29/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VG0400X | 25MA03395700 | NJ | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology | 2084P0800X | 25MA03395700 | NJ | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.