Shanehsaz, Bahareh

Shanehsaz, Bahareh is an sole proprietor health care provider with primary practice located at 196 Princeton Hightstown Rd , West Windsor NJ 08550-1672. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Shanehsaz, Bahareh can be contacted via phone (609) 799-5335.

Contact Information

Primary practice address
196 Princeton Hightstown Rd West Windsor NJ 08550-1672
Phone: (609) 799-5335
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25MA10301200 New Jersey
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1649666165
LBN Legal business name Shanehsaz, Bahareh
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 10th, 2015
Last updated Jun 10th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649666165 NPPES
New Jersey MEDICAID 2858100

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