Provider Demographics
NPI:1881343622
Name:NADEEM, MOONA (DO)
Entity type:Individual
Prefix:
First Name:MOONA
Middle Name:
Last Name:NADEEM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 ELSMERE PL APT 3
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4416
Mailing Address - Country:US
Mailing Address - Phone:914-426-7161
Mailing Address - Fax:
Practice Address - Street 1:2702 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-8701
Practice Address - Country:US
Practice Address - Phone:212-304-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335460207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine