Healthcare Provider Details

I. General information

NPI: 1629904610
Provider Name (Legal Business Name): RADIANT PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 MILLBURN AVE STE 106
MILLBURN NJ
07041-1933
US

IV. Provider business mailing address

90 MILLBURN AVE STE 106
MILLBURN NJ
07041-1933
US

V. Phone/Fax

Practice location:
  • Phone: 669-900-5721
  • Fax:
Mailing address:
  • Phone: 669-900-5721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YASHSAVI SHARAD
Title or Position: CO-OWNER
Credential: DO
Phone: 669-900-5721