Individual
DR. MORTEZA SHAHAMAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 FRANKLIN TPKE, SUITE 104, MAHWAH, NJ 07430
(201) 995-1005
(201) 995-1007
Mailing address
400 FRANKLIN TPKE, SUITE 104, MAHWAH, NJ 07430
(201) 995-1005
(201) 995-1007
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA53340
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
459516
AETNA
—
05
—
501700901
—
NJ
01
—
BP257
OXFORD HEALTH PLANS
—
Enumeration date
09/20/2006
Last updated
12/30/2011
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