Provider Demographics
NPI:1134381015
Name:VRS MEDICAL PLLC
Entity type:Organization
Organization Name:VRS MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAROBEEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-322-2258
Mailing Address - Street 1:5 IVY WAY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08810-1420
Mailing Address - Country:US
Mailing Address - Phone:732-322-2258
Mailing Address - Fax:732-230-3675
Practice Address - Street 1:21518 91ST AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-1217
Practice Address - Country:US
Practice Address - Phone:732-322-2258
Practice Address - Fax:732-230-3675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty