Provider Demographics
NPI:1063154342
Name:SHORT HILLS MEDICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:SHORT HILLS MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SABEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-989-0803
Mailing Address - Street 1:21 KENNEDY LN
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6886
Mailing Address - Country:US
Mailing Address - Phone:908-989-0803
Mailing Address - Fax:715-200-5208
Practice Address - Street 1:159 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1849
Practice Address - Country:US
Practice Address - Phone:908-989-0803
Practice Address - Fax:715-200-5208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty