Healthcare Provider Details

I. General information

NPI: 1144289398
Provider Name (Legal Business Name): KHALIDA SHARAFI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MADISON AVE
MORRISTOWN NJ
07960-7357
US

IV. Provider business mailing address

42 KEATS WAY
MORRISTOWN NJ
07960-5817
US

V. Phone/Fax

Practice location:
  • Phone: 973-267-7272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA06684900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: