Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 25MA08346700 | NJ |
N | 207T00000X | Neurosurgeon | 35089924 | OH |
NPI | 1104021054 |
---|---|
Provider Name | Asif Bashir |
First Address | Edison, NJ 08820-3947 |
Second Address | Edison, NJ 08820-3947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 19/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0250724 | (05) | NJ |