Provider Demographics
NPI:1609494319
Name:INTENSIVIST MD SUPPORT LLC
Entity Type:Organization
Organization Name:INTENSIVIST MD SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-844-9062
Mailing Address - Street 1:441 US HIGHWAY 130
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-2710
Mailing Address - Country:US
Mailing Address - Phone:201-844-9062
Mailing Address - Fax:201-365-5737
Practice Address - Street 1:441 US HIGHWAY 130
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2710
Practice Address - Country:US
Practice Address - Phone:201-844-9062
Practice Address - Fax:201-365-5737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty