Center for Adult Medicine of SNJ PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA06992000 Issued in NJ

Legal business name

CENTER FOR ADULT MEDICINE OF SNJ PA

Practice address

12000 Lincoln Dr West
405, Pavilions @ Greentree
Marlton, NJ 08053

Phone

(856) 985-0203

Fax

(856) 985-0010

NPI assigned

Oct 7, 2008

Organization subpart

No

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

Authorized official

Name

Shahin Michael Mirmanesh, M.D.NPI 1679505325

Title

Physician

Phone

(856) 985-0203

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shahin Michael Mirmanesh, M.D.

  • Specialist
  • Marlton, NJ
  • NPI 1679505325
  NPD Authorized official

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1407007578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3714",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08034",
            "telephone_number": "856-985-0203",
            "fax_number": "856-985-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 LINCOLN DR WEST",
            "address_2": "405, PAVILIONS @ GREENTREE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-985-0203",
            "fax_number": "856-985-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ADULT MEDICINE OF SNJ PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "MIRMANESH",
        "authorized_official_first_name": "SHAHIN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "856-985-0203",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA06992000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Cashin
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• Catherine D. Nicolaides, MD, Inc. (Developmental Pediatrics)
• Barbara A Centanzo
• Center for Counseling and Education
• Center for Family Guidance PC
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• Center for Mindful Health and Acupuncture
• Center for Neurologic Specialty

• Specialist in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.