Provider Demographics
NPI:1114093564
Name:GASHI, SHEREMET (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEREMET
Middle Name:
Last Name:GASHI
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 1:99 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-2413
Mailing Address - Country:US
Mailing Address - Phone:973-429-8354
Mailing Address - Fax:
Practice Address - Street 1:11 RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6306
Practice Address - Country:US
Practice Address - Phone:201-998-1800
Practice Address - Fax:201-998-1891
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA066637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG41554Medicare UPIN