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General NPI Number Information
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NPI Number | 1225124738
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Entity Type | Individual
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Provider Name | ABDUR RAUF SHAD M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 131 MADISON AVENUE 3RD FLOOR
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7360
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Country | US
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Telephone | 973-309-4324
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Fax | 973-587-0303
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Provider Business Mailing Address
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Address Line | PO BOX 174
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City | MOUNTAIN LAKES
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State | NJ
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Zip | 07046-0174
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Country | US
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Telephone | 201-967-8425
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Fax | 201-967-8443
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 25MA07564400
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License Number State | NJ
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