Provider Demographics
NPI:1316165244
Name:NEPHROLOGY CONSULTANTS OF NORTH JERSEY INC
Entity type:Organization
Organization Name:NEPHROLOGY CONSULTANTS OF NORTH JERSEY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKIBAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-253-6996
Mailing Address - Street 1:262 STEILEN AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2822
Mailing Address - Country:US
Mailing Address - Phone:201-253-6996
Mailing Address - Fax:
Practice Address - Street 1:262 STEILEN AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2822
Practice Address - Country:US
Practice Address - Phone:201-253-6996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07732100207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty