Individual
DR. KARAN OMIDVARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
385 PROSPECT AVE STE 204, HACKENSACK, NJ 07601-2570
(551) 996-9190
Mailing address
170 E 87TH ST APT W11A, NEW YORK, NY 10128-2238
(201) 967-8425
(201) 263-4665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
219979
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
139772
NJ
207RP1001X
Pulmonary Disease Physician
219979
NY
208M00000X
Hospitalist Physician
219979
NY
208M00000X
Hospitalist Physician
MA56381
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA05638100
STATE LICENSE
NJ
05
—
80187
—
NJ
Enumeration date
02/06/2006
Last updated
01/07/2020
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