Healthcare Provider Details

I. General information

NPI: 1821033481
Provider Name (Legal Business Name): DARAKHSHAN F SHAMSIE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

889 ALLWOOD RD
CLIFTON NJ
07012-1933
US

IV. Provider business mailing address

889 ALLWOOD RD
CLIFTON NJ
07012-1933
US

V. Phone/Fax

Practice location:
  • Phone: 862-662-2221
  • Fax: 862-661-2230
Mailing address:
  • Phone: 862-662-2221
  • Fax: 862-661-2230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number201125
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number201125-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number25MA12101700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: