Provider Demographics
NPI:1376619817
Name:MEHDI T. SHAARI,M.D.,P.C.
Entity Type:Organization
Organization Name:MEHDI T. SHAARI,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHAARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-867-5557
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:07093-2211
Mailing Address - Country:US
Mailing Address - Phone:201-867-5556
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:07093-2211
Practice Address - Country:US
Practice Address - Phone:201-867-5556
Practice Address - Fax:201-867-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA024208207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0106475000OtherAMERIHEALTH
NJ0055351OtherGHI
NJOK1108OtherHEALTHNET
NJ5176499OtherAETNA
NJHS155OtherOXFORD
NJ52439OtherWELLCHOICE
NJHS155OtherOXFORD
NJ5176499OtherAETNA