MUJTABA NP WALK IN CLINIC PC NPI 1629757323

NPI Information

  • NPI: 1629757323
  • Provider Name: MUJTABA NP WALK IN CLINIC, PC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Doing Business As: STAT PRIMARY NP CLINIC
  • CLIA Number: 31D2329757
  • Address: 2123 KENNEDY BLVD
    NORTH BERGEN, NJ
    ZIP 07047
  • Phone: (973) 200-2430

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NPI Details

MUJTABA NP WALK IN CLINIC, PC is a family nurse practitioner in North Bergen, NJ. MUJTABA NP WALK IN CLINIC, PC NPI is 1629757323. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Stat Primary Np Clinic.

The provider's business location address is:

2123 KENNEDY BLVD
NORTH BERGEN, NJ
ZIP 07047
Phone: (973) 200-2430

The provider's authorized official is Assad Mujtaba .
The authorized official title is President and has the following contact phone number (973) 200-2430.

The CLIA number assigned to this NPI record is 31D2329757 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/12/2023 and was last updated on 11/1/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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