Provider Demographics
NPI:1972527950
Name:ELAMIR, MAZHAR
Entity type:Individual
Prefix:DR
First Name:MAZHAR
Middle Name:
Last Name:ELAMIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1906
Mailing Address - Country:US
Mailing Address - Phone:201-333-5363
Mailing Address - Fax:
Practice Address - Street 1:192 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1906
Practice Address - Country:US
Practice Address - Phone:201-333-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04785700207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1265008Medicaid
NJC55141Medicare UPIN
NJ450946Medicare PIN