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General NPI Number Information
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NPI Number | 1992770168
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Entity Type | Individual
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Provider Name | NAZLY M SHARIATI MD
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 MADISON AVE CAROL G. SIMON CANCER CENTER
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6136
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Country | US
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Telephone | 908-273-4949
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Fax | 908-522-6105
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Provider Business Mailing Address
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Address Line | PO BOX 123
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City | MORRISTOWN
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State | NJ
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Zip | 07963-0123
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Country | US
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Telephone | 908-273-4949
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Fax | 908-522-6105
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 25MA06634100
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License Number State | NJ
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