Provider Demographics
NPI:1316953730
Name:NADEREH BEHNAM,M.D. LLC.
Entity type:Organization
Organization Name:NADEREH BEHNAM,M.D. LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NADEREH
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHNAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-790-7090
Mailing Address - Street 1:502 HAMBURG TPKE STE 103
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-8446
Mailing Address - Country:US
Mailing Address - Phone:973-790-7090
Mailing Address - Fax:973-790-6807
Practice Address - Street 1:502 HAMBURG TPKE STE 103
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-8446
Practice Address - Country:US
Practice Address - Phone:973-790-7090
Practice Address - Fax:973-790-6807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty