Healthcare Provider Details

I. General information

NPI: 1053604520
Provider Name (Legal Business Name): JEHDHUN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 WILLIAMSON ST STE 203
ELIZABETH NJ
07202-3671
US

IV. Provider business mailing address

715 OLD RARITAN RD
EDISON NJ
08820-1021
US

V. Phone/Fax

Practice location:
  • Phone: 732-491-9597
  • Fax: 973-261-5142
Mailing address:
  • Phone: 732-491-9597
  • Fax: 973-261-5142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MEHERWAN B JOSHI
Title or Position: OWNER
Credential: MD
Phone: 732-491-9597