Provider Demographics
NPI:1811977440
Name:ESHKAR, NOAM SIMON (MD)
Entity type:Individual
Prefix:MR
First Name:NOAM
Middle Name:SIMON
Last Name:ESHKAR
Suffix:
Gender:M
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:PO BOX 3271
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-3271
Mailing Address - Country:US
Mailing Address - Phone:732-321-7545
Mailing Address - Fax:732-767-2968
Practice Address - Street 1:65 JAMES ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3947
Practice Address - Country:US
Practice Address - Phone:732-321-7545
Practice Address - Fax:732-767-2968
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA067623002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7858108Medicaid
NJ608451Medicare ID - Type Unspecified
NJ7858108Medicaid