Shree Tara Diversified

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SHREE TARA DIVERSIFIED

Doing business as

DeRosa Medical Supplies

Practice address

2115 Bergenline Ave
Union City, NJ 07087-3507

Phone

(201) 766-5538

Fax

(201) 319-9340

NPI assigned

Oct 21, 2022

Organization subpart

No

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

Authorized official

Name

Kushyup Shah, MD

Title

Owner

Phone

(201) 766-5538

Specialties & licenses 2

Addresses

Other names 1

• DeRosa Medical Supplies Doing business as

Locations

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666310400000",
    "number": "1508583493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 BERGENLINE AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070873507",
            "telephone_number": "201-766-5538",
            "fax_number": "201-319-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 BERGENLINE AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070873507",
            "telephone_number": "201-766-5538",
            "fax_number": "201-319-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHREE TARA DIVERSIFIED",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KUSHYUP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-766-5538",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeRosa Medical Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shrey Shah, DDS
• Rashi Sharma, MD
• Surendra M Sharma, M.D.
• Rachel Shepherd
• Shine Forward ABA LLC
• Shreeji RX LLC
• Amanda P Shukla, DO
• Paresh Parashar Shukla, M.D.
• Sidon LLC
• Simon B Santos Medical Group LLC

• Durable Medical Equipment & Medical Supplies in Union City, NJ
• Providers in Union City, NJ by specialty
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; 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.