Mirza, Imran A

Mirza, Imran A is an sole proprietor health care provider with primary practice located at 1132 Cooper St , Deptford NJ 08096-3014. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Ambulatory Health Care Facilities / Urgent Care. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Mirza, Imran A can be contacted via phone (856) 848-8060.

Contact Information

Primary practice address
1132 Cooper St Deptford NJ 08096-3014
Phone: (856) 848-8060
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25MA08024700 New Jersey
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X MD431989 Pennsylvania
Ambulatory Health Care Facilities / Urgent Care 261QU0200X 25MA08024700 New Jersey

Profile Details

NPI number 1376573204
LBN Legal business name Mirza, Imran A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 4th, 2006
Last updated Sep 22nd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376573204 NPPES
Pennsylvania MEDICAID 1019810230002
Pennsylvania MEDICAID 1019810230001
Pennsylvania Other 1980195

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