Healthcare Provider Details

I. General information

NPI: 1669526133
Provider Name (Legal Business Name): NAGARSHETH, MD.,PA.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PARLIN DR STE B
PARLIN NJ
08859-2263
US

IV. Provider business mailing address

3 PARLIN DR STE B
PARLIN NJ
08859-2263
US

V. Phone/Fax

Practice location:
  • Phone: 732-238-8500
  • Fax: 732-238-8501
Mailing address:
  • Phone: 732-238-8500
  • Fax: 732-238-8501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA03412000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number25MA03412000
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number25MA03594100
License Number StateNJ

VIII. Authorized Official

Name: DR. HARISH N NAGARSHETH
Title or Position: PRESIDENT
Credential: MD
Phone: 732-238-8500