Provider Demographics
NPI:1487432878
Name:RA'OOF-SALEEM, TASWIYAH (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:TASWIYAH
Middle Name:
Last Name:RA'OOF-SALEEM
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MRS
Other - First Name:TASWIYAH
Other - Middle Name:
Other - Last Name:RAOOF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:50A NEWARK WAY
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3310
Mailing Address - Country:US
Mailing Address - Phone:973-885-0475
Mailing Address - Fax:
Practice Address - Street 1:935 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2731
Practice Address - Country:US
Practice Address - Phone:201-478-5800
Practice Address - Fax:201-478-5814
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14844500363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology