Provider Demographics
NPI:1740818285
Name:RASOOL, SHEREEN HAWAL (MD)
Entity type:Individual
Prefix:DR
First Name:SHEREEN
Middle Name:HAWAL
Last Name:RASOOL
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 1:1414 MAIN AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2157
Mailing Address - Country:US
Mailing Address - Phone:973-772-6999
Mailing Address - Fax:
Practice Address - Street 1:1414 MAIN AVE STE 14
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2157
Practice Address - Country:US
Practice Address - Phone:973-772-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA11878400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program