Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 27OA00663300 | NJ |
Y | 152W00000X | Optometrist | 27OM00131700 | NJ |
NPI | 1003129495 |
---|---|
Provider Name | Dr. Mahsa Shekari |
First Address | Hackensack, NJ 07601 |
Second Address | Hackensack, NJ 07601-5913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2010 |
Last Update Date | 20/10/2015 |