Provider Demographics
NPI:1932133923
Name:BESHARA, RAAFAT H (MD)
Entity Type:Individual
Prefix:MR
First Name:RAAFAT
Middle Name:H
Last Name:BESHARA
Suffix:
Gender:M
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:PO BOX 10439
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08650-4039
Mailing Address - Country:US
Mailing Address - Phone:609-581-5303
Mailing Address - Fax:609-631-6839
Practice Address - Street 1:2119 HIGHWAY 33
Practice Address - Street 2:SUITE B
Practice Address - City:HAMILTON SQ
Practice Address - State:NJ
Practice Address - Zip Code:08690-1740
Practice Address - Country:US
Practice Address - Phone:609-581-5303
Practice Address - Fax:609-631-6839
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08010200207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0106917Medicaid
NJP00697815OtherRR MEDICARE
NJ104083M5FMedicare PIN
NJP00697815OtherRR MEDICARE