Provider Demographics
NPI:1811979941
Name:BHOORI, NAFISA YOUSUF (MD)
Entity type:Individual
Prefix:
First Name:NAFISA
Middle Name:YOUSUF
Last Name:BHOORI
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:PO BOX 8519
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-8519
Mailing Address - Country:US
Mailing Address - Phone:732-460-9840
Mailing Address - Fax:732-460-9848
Practice Address - Street 1:30 SHREWSBURY PLAZA
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4332
Practice Address - Country:US
Practice Address - Phone:732-542-0002
Practice Address - Fax:732-542-2992
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA6504800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5208734OtherAETNA
NY0X4221OtherEMPIRE BC/BS
133863OtherAETNA CAPITATION
NJ4610111OtherCIGNA
NJ7773501Medicaid
NJ1868030OtherUNITED HEALTHCARE
NJP1018467OtherOXFORD
2312936OtherAETNA HMO
NJF04205OtherHEALTH NET
110154023OtherRAILROAD MEDICARE
5208734OtherAETNA
G61216Medicare UPIN