Active NPI
Waldburg Zomorodi, MD
- Psychiatry Physician
- Princeton, NJ
National Provider Identifier
1619003597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25MA030247
- Practice address
- 905 Herrontown Rd
Princeton, NJ 08540-1901 - Phone
- (609) 497-3327
- Fax
- (609) 497-3370
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25MA030247 | NJ | Primary |
Addresses
Primary practice location
905 Herrontown Rd
Princeton, NJ 08540-1901
Mailing address
905 Herrontown Rd
Princeton, NJ 08540-1901
Phone (609) 497-3327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA030247 | NJ | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rutgers Health - Behavioral Health | Psychiatry | Past | Accepting new patients |
| Rutgers Health - Behavioral Health | Psychiatry | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- NPI 1891956298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619003597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 HERRONTOWN RD",
"city": "PRINCETON",
"state": "NJ",
"postal_code": "085401901",
"telephone_number": "609-497-3327",
"fax_number": "609-497-3370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 HERRONTOWN RD",
"city": "PRINCETON",
"state": "NJ",
"postal_code": "085401901",
"telephone_number": "609-497-3327",
"fax_number": "609-497-3370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZOMORODI",
"first_name": "WALDBURG",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "25MA030247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Princeton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.