Healthcare Provider Details

I. General information

NPI: 1043259898
Provider Name (Legal Business Name): EMRAN SALAHUDDIN SHEIKH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 ROUTE 17 FL 11 SUITE 11019
RUTHERFORD NJ
07070-2557
US

IV. Provider business mailing address

201 ROUTE 17 FL 11 SUITE 11019
RUTHERFORD NJ
07070-2557
US

V. Phone/Fax

Practice location:
  • Phone: 201-549-8860
  • Fax: 201-549-8861
Mailing address:
  • Phone: 201-549-8860
  • Fax: 201-549-8861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberMD424633
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number25MA07791700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: