Provider Demographics
NPI:1659317824
Name:MAKAR, SHEREEN ANES (MD)
Entity Type:Individual
Prefix:
First Name:SHEREEN
Middle Name:ANES
Last Name:MAKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 CRAIG AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1238
Mailing Address - Country:US
Mailing Address - Phone:718-501-3257
Mailing Address - Fax:
Practice Address - Street 1:120 EAGLE ROCK AVE STE 154
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-3168
Practice Address - Country:US
Practice Address - Phone:201-447-4772
Practice Address - Fax:862-701-6444
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08096100174400000X, 208100000X
NY241250208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02941335Medicaid
NY236511Medicare PIN