Provider Demographics
NPI:1457247785
Name:BESHAI, MADONA AMGAD (OD)
Entity type:Individual
Prefix:DR
First Name:MADONA
Middle Name:AMGAD
Last Name:BESHAI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MADONA
Other - Middle Name:AMGAD
Other - Last Name:NASIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:111 DEAN DR
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2764
Mailing Address - Country:US
Mailing Address - Phone:201-567-5995
Mailing Address - Fax:
Practice Address - Street 1:111 DEAN DR
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-2764
Practice Address - Country:US
Practice Address - Phone:201-567-5995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00736300152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist