Provider Demographics
NPI:1740236975
Name:FRIED, SHARON ZELOVIC (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ZELOVIC
Last Name:FRIED
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 1:180 N DEAN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2534
Mailing Address - Country:US
Mailing Address - Phone:201-569-9800
Mailing Address - Fax:201-568-2941
Practice Address - Street 1:180 N DEAN ST
Practice Address - Street 2:SUITE 2 SOUTH
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2534
Practice Address - Country:US
Practice Address - Phone:201-569-9800
Practice Address - Fax:201-568-2941
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA04730800207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
448679Medicare ID - Type Unspecified
NJC54906Medicare UPIN