Provider Demographics
NPI:1013910942
Name:AMIN, HARIS IRFAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HARIS
Middle Name:IRFAN
Last Name:AMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:780 ROUTE 37 W
Mailing Address - Street 2:STE 200
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5059
Mailing Address - Country:US
Mailing Address - Phone:732-797-1855
Mailing Address - Fax:732-797-1856
Practice Address - Street 1:780 ROUTE 37 W
Practice Address - Street 2:STE 200
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5059
Practice Address - Country:US
Practice Address - Phone:732-797-1855
Practice Address - Fax:732-797-1856
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07562000207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
G64461Medicare UPIN
NJ075911SCJMedicare ID - Type Unspecified