Provider Demographics
NPI:1245590512
Name:N.D. SHARIATI M.D. PC
Entity Type:Organization
Organization Name:N.D. SHARIATI M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:NASSEREDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-234-2295
Mailing Address - Street 1:2345 LAMINGTON RD STE 103
Mailing Address - Street 2:
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921-2612
Mailing Address - Country:US
Mailing Address - Phone:908-234-2295
Mailing Address - Fax:908-234-0579
Practice Address - Street 1:2345 LAMINGTON RD STE 103
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-2612
Practice Address - Country:US
Practice Address - Phone:908-234-2295
Practice Address - Fax:908-234-0579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC55022Medicare UPIN