MEDICARE: MEHDI T. SHAARI,M.D.,P.C.

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	207Y00000X	Otolaryngology Physician	MA024208	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0106475000	OTHER	NJ	AMERIHEALTH
2	0055351	OTHER	NJ	GHI
3	OK1108	OTHER	NJ	HEALTHNET
4	5176499	OTHER	NJ	AETNA
5	HS155	OTHER	NJ	OXFORD
6	52439	OTHER	NJ	WELLCHOICE

General Provider Information

NPI Number	:	1376619817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEHDI T. SHAARI,M.D.,P.C.

Provider Business Mailing Address
First Line	:	413 60TH ST
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-2211
Country	:	US
Telephone Number	:	201-867-5556
Fax Number	:	201-867-5566

Provider Business Practice Location Address
First Line	:	413 60TH ST
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-2211
Country	:	US
Telephone Number	:	201-867-5556
Fax Number	:	201-867-5566

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MEHDI T. SHAARI
Credential	:	M.D.
Telephone Number	:	201-867-5557

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	04/26/2016

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