Active NPI
Nisreen Abdelaziz
- Medical Physician Assistant
- Hoboken, NJ
National Provider Identifier
1720562077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 25MP00593300
- Practice address
- 231 Washington St
Hoboken, NJ 07030-7221 - Phone
- (201) 754-1006
- NPI assigned
- Sep 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 022635 | NY | |
| Medical Physician Assistant | 363AM0700X | 25MP00593300 | NJ | Primary |
Addresses
Primary practice location
231 Washington St
Hoboken, NJ 07030-7221
Mailing address
1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300
Other practice location 1
327 Beach 19th St
Far Rockaway, NY 11691-4423
Phone (718) 869-7000
Other practice location 2
1000 N Village Ave
Rockville Centre, NY 11570
Phone (516) 705-2525
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00593300 | NJ | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611878400000",
"number": "1720562077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 DIAMOND HILL RD",
"city": "BERKELEY HEIGHTS",
"state": "NJ",
"postal_code": "079222104",
"telephone_number": "908-273-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 WASHINGTON ST",
"city": "HOBOKEN",
"state": "NJ",
"postal_code": "070307221",
"telephone_number": "201-754-1006"
}
],
"practiceLocations": [
{
"address_1": "327 Beach 19th St",
"address_purpose": "LOCATION",
"city": "Far Rockaway",
"state": "NY",
"postal_code": "116914423",
"country_code": "US",
"telephone_number": "718-869-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 N Village Ave",
"address_purpose": "LOCATION",
"city": "Rockville Centre",
"state": "NY",
"postal_code": "11570",
"country_code": "US",
"telephone_number": "516-705-2525",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ABDELAZIZ",
"first_name": "NISREEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-22",
"last_updated": "2021-01-29",
"certification_date": "2021-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "022635",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NJ",
"license": "25MP00593300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hoboken, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.