Provider Demographics
NPI:1194788570
Name:NEJAT, IRAJ (MD)
Entity type:Individual
Prefix:DR
First Name:IRAJ
Middle Name:
Last Name:NEJAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-1168
Mailing Address - Country:US
Mailing Address - Phone:973-334-3003
Mailing Address - Fax:973-334-0863
Practice Address - Street 1:550 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOONTON
Practice Address - State:NJ
Practice Address - Zip Code:07005-1168
Practice Address - Country:US
Practice Address - Phone:973-334-3003
Practice Address - Fax:973-334-0863
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28808208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics