Abolghassem Sheiban, M.D., P.a.

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

25MA02281800 Issued in NJ

Legal business name

ABOLGHASSEM SHEIBAN, M.D., P.A.

Practice address

190 Dayton St
2ND Floor
Ridgewood, NJ 07450-4422

Phone

(201) 445-0469

Fax

(201) 447-4755

NPI assigned

Aug 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Abolghassem G. Sheiban, M.D.

Title

President

Phone

(201) 445-0469

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1205083466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 DAYTON ST",
            "address_2": "2ND FLOOR",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504422",
            "telephone_number": "201-445-0469",
            "fax_number": "201-447-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 DAYTON ST",
            "address_2": "2ND FLOOR",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504422",
            "telephone_number": "201-445-0469",
            "fax_number": "201-447-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABOLGHASSEM SHEIBAN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "SHEIBAN",
        "authorized_official_first_name": "ABOLGHASSEM",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-445-0469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "NJ",
            "license": "25MA02281800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Legal Medicine in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Legal Medicine in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.