Provider Demographics
NPI:1588610851
Name:IRADJ SHARIM, MD, PA
Entity Type:Organization
Organization Name:IRADJ SHARIM, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRADJ
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-393-4911
Mailing Address - Street 1:40 FULD ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-5247
Mailing Address - Country:US
Mailing Address - Phone:609-393-4911
Mailing Address - Fax:609-394-6770
Practice Address - Street 1:40 FULD ST
Practice Address - Street 2:SUITE 402
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-5247
Practice Address - Country:US
Practice Address - Phone:609-393-4911
Practice Address - Fax:609-394-6770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2958406Medicaid
NJ2958406Medicaid