Provider Demographics
NPI:1417246141
Name:AHADI, SAHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:
Last Name:AHADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAHAR
Other - Middle Name:
Other - Last Name:ELIASSI-RAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1440 BEACON ST
Mailing Address - Street 2:APT810
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2092
Mailing Address - Country:US
Mailing Address - Phone:781-771-4257
Mailing Address - Fax:
Practice Address - Street 1:185 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2757
Practice Address - Country:US
Practice Address - Phone:973-972-5209
Practice Address - Fax:973-972-5059
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program