Healthcare Provider Details

I. General information

NPI: 1518198217
Provider Name (Legal Business Name): MAHRUKH ASIF BASHIR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAHRUKH SHERDIL MBBS

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 JAMES ST
EDISON NJ
08820-3947
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 732-321-7010
  • Fax: 732-654-1584
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA10052300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: