Shirin Jadidi, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

25MA05391800 Issued in NJ

Practice address

12 McVickers LN
Mendham, NJ 07945-2936

Phone

(973) 543-8861

NPI assigned

Sep 23, 2013

Last updated

Sep 23, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379894400000",
    "number": "1386070340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MCVICKERS LN",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079452936",
            "telephone_number": "973-543-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MCVICKERS LN",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079452936",
            "telephone_number": "973-543-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JADIDI",
        "first_name": "SHIRIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MA05391800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Blood Hydock, MPH, CHES, NBC-HWC
• Iconic Medical and Wellness Centers
• Clelia C Ilacqua, DDS
• Christina Mary Ioannou
• Richard Anthony Irlando, MD
• Katherine Jannarone
• Michelle Juhasz, LCSW
• Linda Y Kalnins, MD
• Patrick Mullen Kelly, MA, LAC, NCC
• Bruce Kemmerer

• Allergy & Immunology Physician in Mendham, NJ
• Providers in Mendham, NJ by specialty
• Allergy & Immunology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.