Shamra Medical Laboratory Limited Liability Company

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA072160000 Issued in NJ

Legal business name

SHAMRA MEDICAL LABORATORY LIMITED LIABILITY COMPANY

Practice address

668 N Beers St
Suite 104
Holmdel, NJ 07733-1526

Phone

(732) 888-0017

Fax

(732) 888-0097

NPI assigned

Nov 18, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ammar Bazerbashi, M.D

Title

Medical Doctor

Phone

(732) 888-0017

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1063789170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 N BEERS ST",
            "address_2": "SUITE 104",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331526",
            "telephone_number": "732-888-0017",
            "fax_number": "732-888-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 N BEERS ST",
            "address_2": "SUITE 104",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331526",
            "telephone_number": "732-888-0017",
            "fax_number": "732-888-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMRA MEDICAL LABORATORY LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "BAZERBASHI",
        "authorized_official_first_name": "AMMAR",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "732-888-0017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA072160000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hena Shah
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• Internal Medicine Physician in Holmdel, NJ
• Providers in Holmdel, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.