Provider Demographics
NPI:1033452487
Name:MGHARI, ANWAR (FNP)
Entity Type:Individual
Prefix:MR
First Name:ANWAR
Middle Name:
Last Name:MGHARI
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1702
Mailing Address - Country:US
Mailing Address - Phone:201-655-9297
Mailing Address - Fax:
Practice Address - Street 1:106 DAVIS DR
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1702
Practice Address - Country:US
Practice Address - Phone:201-655-9297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY725688163W00000X
NY351610363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1033452487OtherREGISTERED NURSE
NY363LF0000XOtherFAMILY NURSE PRACTITIONER