MEDICARE: DR. HARIS IRFAN AMIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0107X	Retina Specialist (Ophthalmology) Physician	25MA07562000	NJ

General Provider Information

NPI Number	:	1013910942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARIS IRFAN AMIN MD

Provider Business Mailing Address
First Line	:	780 ROUTE 37 W
Second Line	:	STE 200
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-5059
Country	:	US
Telephone Number	:	732-797-1855
Fax Number	:	732-797-1856

Provider Business Practice Location Address
First Line	:	780 ROUTE 37 W
Second Line	:	STE 200
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-5059
Country	:	US
Telephone Number	:	732-797-1855
Fax Number	:	732-797-1856

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	04/04/2017

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