Provider Demographics
NPI:1033291711
Name:HAMIRANI, KAMRAN ISMAIL (MD)
Entity Type:Individual
Prefix:
First Name:KAMRAN
Middle Name:ISMAIL
Last Name:HAMIRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 501
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-0501
Mailing Address - Country:US
Mailing Address - Phone:201-996-0055
Mailing Address - Fax:201-996-0584
Practice Address - Street 1:255 W SPRING VALLEY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1445
Practice Address - Country:US
Practice Address - Phone:201-996-0055
Practice Address - Fax:201-996-0584
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07483600207RC0000X, 207RI0011X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0029165Medicaid
H73299Medicare UPIN
NJ0029165Medicaid