Mohammad Ayub Bajwa, MD

Individual provider Active NPI Gastroenterology Physician · Bloomfield, NJ

NPI 1720162951 · NPPES record last updated Jul 8, 2010

Key facts

NPI
1720162951
Entity type
Individual (NPI type 1)
Primary specialty
Gastroenterology Physician 207RG0100X
License
25MA03281800 (NJ)
Practice address
14 Washington Street
Bloomfield, NJ 07003
Phone
(973) 429-0601
Fax
(973) 429-3305
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20101119000945 NJ Practitioner - Internal Medicine
Practitioner - Gastroenterology
4385830082

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 25MA03281800 NJ Yes

Addresses

Primary practice location

14 Washington Street
Bloomfield, NJ 07003

Mailing address

14 Washington Street
Bloomfield, NJ 07003
Phone (973) 429-0601

Other identifiers

IdentifierTypeStateIssuer
2964406MedicaidNJ

Other providers in Bloomfield, NJ

All providers in Bloomfield, NJ · Gastroenterology Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.