Provider Demographics
NPI:1225104029
Name:SHAARI, MEHDI T (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHDI
Middle Name:T
Last Name:SHAARI
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 1:413-60TH ST.
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093
Mailing Address - Country:US
Mailing Address - Phone:201-867-5557
Mailing Address - Fax:201-867-5566
Practice Address - Street 1:413-60TH ST.
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093
Practice Address - Country:US
Practice Address - Phone:201-867-5557
Practice Address - Fax:201-867-5566
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA024208207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHEALTHNETOtherOK1108
NJ52439OtherWELLCHOICE
NJHS155OtherOXFORD
NJ0106475000OtherAMERIHEALTH
NJ0055351OtherGHI
NJ5176499OtherAETNA
NJ52439OtherWELLCHOICE
NJ0106475000OtherAMERIHEALTH