Provider Demographics
NPI:1881757268
Name:DANISH, SHABBAR F (MD)
Entity type:Individual
Prefix:
First Name:SHABBAR
Middle Name:F
Last Name:DANISH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:19 DAVIS AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4488
Mailing Address - Country:US
Mailing Address - Phone:732-749-0003
Mailing Address - Fax:732-974-0366
Practice Address - Street 1:19 DAVIS AVENUE
Practice Address - Street 2:HOPE TOWER 4TH FL.
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753
Practice Address - Country:US
Practice Address - Phone:732-974-0003
Practice Address - Fax:732-974-0336
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2021-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08350900207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0182699Medicaid
NJP00883886OtherRR MCR PTAN
NJ144454C5WMedicare PIN