Provider Demographics
NPI:1366844870
Name:HAQ, URWAH (DPM)
Entity type:Individual
Prefix:
First Name:URWAH
Middle Name:
Last Name:HAQ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 468
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-0468
Mailing Address - Country:US
Mailing Address - Phone:954-873-3438
Mailing Address - Fax:
Practice Address - Street 1:1529 ROUTE 206 STE L
Practice Address - Street 2:
Practice Address - City:TABERNACLE
Practice Address - State:NJ
Practice Address - Zip Code:08088-8801
Practice Address - Country:US
Practice Address - Phone:856-422-2323
Practice Address - Fax:856-872-4544
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00336100213EP1101X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery