Provider Demographics
NPI:1306814900
Name:NASR, SHERIF A
Entity Type:Individual
Prefix:DR
First Name:SHERIF
Middle Name:A
Last Name:NASR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 RIVERSIDE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:PINE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07058-9391
Mailing Address - Country:US
Mailing Address - Phone:201-599-9044
Mailing Address - Fax:201-599-9066
Practice Address - Street 1:25 RIVERSIDE DR STE 2
Practice Address - Street 2:
Practice Address - City:PINE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07058-9391
Practice Address - Country:US
Practice Address - Phone:201-599-9044
Practice Address - Fax:201-599-9066
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05880800207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0032271Medicaid
NJ070648Medicare PIN
NJ0032271Medicaid