Provider Demographics
NPI:1700289303
Name:HEDARI, CARINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CARINE
Middle Name:
Last Name:HEDARI
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 1:137 KIEL AVE
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2543
Mailing Address - Country:US
Mailing Address - Phone:856-426-8764
Mailing Address - Fax:
Practice Address - Street 1:430 EAST 29TH STREET
Practice Address - Street 2:DIVISION OF PEDIATRIC INFECTIOUS DISEASES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:646-501-2469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-27
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY289831-012080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program