MEDICARE: BEHDOKHT DANESHVAR 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	207R00000X	Internal Medicine Physician	MA069585	NJ
2	208M00000X	Hospitalist Physician	25MA06958500	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093745473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEHDOKHT DANESHVAR MD

Provider Business Mailing Address
First Line	:	1015 NEW RD
Second Line	:	2ND FLOOR
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1660
Country	:	US
Telephone Number	:	609-485-0300
Fax Number	:	609-646-7140

Provider Business Practice Location Address
First Line	:	1015 NEW RD
Second Line	:	2ND FLOOR
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1660
Country	:	US
Telephone Number	:	609-485-0300
Fax Number	:	609-646-7140

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	02/22/2016

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Directions to “ BEHDOKHT DANESHVAR MD” Practice Location

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