Provider Demographics
NPI:1437233921
Name:TAHZIB, MUNIRIH NURA (MD)
Entity type:Individual
Prefix:DR
First Name:MUNIRIH
Middle Name:NURA
Last Name:TAHZIB
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 1:405 NORTHFIELD AVE STE LL2
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3023
Mailing Address - Country:US
Mailing Address - Phone:973-736-4442
Mailing Address - Fax:
Practice Address - Street 1:405 NORTHFIELD AVE STE LL2
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-3023
Practice Address - Country:US
Practice Address - Phone:973-736-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07843300207KA0200X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
H79690Medicare UPIN