Provider Demographics
NPI:1326320870
Name:ZANDIEH, SHADI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHADI
Middle Name:
Last Name:ZANDIEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 REHILL AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2519
Mailing Address - Country:US
Mailing Address - Phone:510-684-1525
Mailing Address - Fax:908-279-8515
Practice Address - Street 1:110 REHILL AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2519
Practice Address - Country:US
Practice Address - Phone:510-684-1525
Practice Address - Fax:908-279-8515
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-11
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital