Provider Demographics
NPI:1174676167
Name:OSHIDAR, XERXES (DC)
Entity Type:Individual
Prefix:
First Name:XERXES
Middle Name:
Last Name:OSHIDAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-2901
Mailing Address - Country:US
Mailing Address - Phone:609-261-7562
Mailing Address - Fax:609-261-7562
Practice Address - Street 1:227 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-2901
Practice Address - Country:US
Practice Address - Phone:609-261-7562
Practice Address - Fax:609-261-7562
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCO9080-5B111N00000X
NJMC00580900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2395999000OtherAMERIHEALTH KEYSTONE HMO
NY5898227OtherGHI ALIGNIS
NYNY0796OtherHEALTHNET LANDMARK NY
NYP2198428OtherOXFORD TRIAD NYNJ
NY640635OtherACN NY NJ
NY1030676OtherCIGNA ASH NY NJ
NY2945983OtherAETNA ACN NY NJ
NYX5X771OtherBCBS NY
NJNJ05809OtherHEALTHNET LANDMARK NJ
NYP2198428OtherOXFORD TRIAD NYNJ
NYX5X771OtherBCBS NY
NYNY0796OtherHEALTHNET LANDMARK NY