Healthcare Provider Details

I. General information

NPI: 1619474566
Provider Name (Legal Business Name): BEHZAD AMOOZGAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2018
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 W PARKWAY
POMPTON PLAINS NJ
07444-1647
US

IV. Provider business mailing address

PO BOX 416457
BOSTON MA
02241-1010
US

V. Phone/Fax

Practice location:
  • Phone: 973-831-5000
  • Fax: 973-907-1034
Mailing address:
  • Phone: 844-362-1735
  • Fax: 973-290-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA207325
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number25MA11664500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: