Provider Demographics
NPI:1215952775
Name:DARA, PARVEZ (MD)
Entity type:Individual
Prefix:DR
First Name:PARVEZ
Middle Name:
Last Name:DARA
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 1:214 COMMONS WAY
Mailing Address - Street 2:BLDG B
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755
Mailing Address - Country:US
Mailing Address - Phone:732-240-4004
Mailing Address - Fax:732-240-0917
Practice Address - Street 1:214 COMMONS WAY
Practice Address - Street 2:BLDG B
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755
Practice Address - Country:US
Practice Address - Phone:732-240-4004
Practice Address - Fax:732-240-0917
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA03329200207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3104702Medicaid
A84423Medicare UPIN
NJ461693Medicare ID - Type Unspecified