Provider Demographics
NPI:1407293764
Name:BAHAR, RAMAZAN (APN)
Entity Type:Individual
Prefix:MR
First Name:RAMAZAN
Middle Name:
Last Name:BAHAR
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 STEILEN AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2822
Mailing Address - Country:US
Mailing Address - Phone:201-820-7737
Mailing Address - Fax:
Practice Address - Street 1:59 BIRCH ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07522-1403
Practice Address - Country:US
Practice Address - Phone:973-968-4317
Practice Address - Fax:973-942-1228
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00435500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ342951Medicare PIN