Provider Demographics
NPI:1184831406
Name:NAKHJO, SHOMAF (DO)
Entity Type:Individual
Prefix:
First Name:SHOMAF
Middle Name:
Last Name:NAKHJO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 HIGH ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-9602
Mailing Address - Country:US
Mailing Address - Phone:973-383-2222
Mailing Address - Fax:973-383-3344
Practice Address - Street 1:183 HIGH ST STE 1100
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-9602
Practice Address - Country:US
Practice Address - Phone:973-383-2222
Practice Address - Fax:973-383-3344
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-243324208600000X
NJ25MB08739300208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery