Provider Demographics
NPI:1578896239
Name:IRAJ NEJAT, M.D. ,F.A.A.P.,P.A.
Entity Type:Organization
Organization Name:IRAJ NEJAT, M.D. ,F.A.A.P.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:NEJAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-334-3003
Mailing Address - Street 1:550 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-1168
Mailing Address - Country:US
Mailing Address - Phone:973-334-3003
Mailing Address - Fax:973-334-0863
Practice Address - Street 1:550 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005-1168
Practice Address - Country:US
Practice Address - Phone:973-334-3003
Practice Address - Fax:973-334-0863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty