Provider Demographics
NPI:1164507919
Name:MAZA, SHARON (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:MAZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:83 SUMMIT AVE
Mailing Address - Street 2:REAR SUITE
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1262
Mailing Address - Country:US
Mailing Address - Phone:201-488-1320
Mailing Address - Fax:201-488-1596
Practice Address - Street 1:83 SUMMIT AVE
Practice Address - Street 2:REAR SUITE
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1262
Practice Address - Country:US
Practice Address - Phone:201-488-1320
Practice Address - Fax:201-488-1596
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05907800207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ085539Medicare ID - Type UnspecifiedCARDIO CARE ASSOCIATES