Provider Demographics
NPI:1962501304
Name:SHAMSI, ZAHIRA BAKHTIAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAHIRA
Middle Name:BAKHTIAR
Last Name:SHAMSI
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 1:14 CONCORD AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5233
Mailing Address - Country:US
Mailing Address - Phone:732-563-6630
Mailing Address - Fax:
Practice Address - Street 1:1273 BOUND BROOK RD
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:NJ
Practice Address - Zip Code:08846-1490
Practice Address - Country:US
Practice Address - Phone:732-563-6630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 61524207RG0300X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ019865Medicare PIN
NJG80506Medicare UPIN