Provider Demographics
NPI:1710280292
Name:SOHEIL PAJOOHI, M.D., PA
Entity Type:Organization
Organization Name:SOHEIL PAJOOHI, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SOHEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAJOOHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-473-8269
Mailing Address - Street 1:1373 BROAD ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-4200
Mailing Address - Country:US
Mailing Address - Phone:973-473-8269
Mailing Address - Fax:973-473-0065
Practice Address - Street 1:1373 BROAD ST
Practice Address - Street 2:SUITE 308
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-4200
Practice Address - Country:US
Practice Address - Phone:973-473-8269
Practice Address - Fax:973-473-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03106500207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC60741Medicare UPIN
101470Medicare PIN