Voorhees Medical Home

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA09026400 Issued in NJ

Legal business name

VOORHEES MEDICAL HOME

Doing business as

Mirmanesh Medicine

Practice address

100 Route 73
Voorhees, NJ 08043-9575

Phone

(856) 753-7374

Fax

(856) 753-1137

NPI assigned

Feb 5, 2017

Last updated

Feb 5, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shahram Jay Mirmanesh, MD

Title

Managing Partner

Phone

(609) 238-0870

Specialties & licenses 3

Addresses

Other names 1

• Mirmanesh Medicine Doing business as

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

{
    "created_epoch": "1486252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486252800000",
    "number": "1699213165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 73",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439575",
            "telephone_number": "856-753-7374",
            "fax_number": "856-753-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROUTE 73",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439575",
            "telephone_number": "856-753-7374",
            "fax_number": "856-753-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOORHEES MEDICAL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-05",
        "last_updated": "2017-02-05",
        "status": "A",
        "authorized_official_last_name": "MIRMANESH",
        "authorized_official_first_name": "SHAHRAM",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "609-238-0870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA06842200",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA09026400",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA09469200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mirmanesh Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph J. Vondran, R. PH.
• Voorhees Dental Smiles
• Voorhees Family Dentistry, LLC
• Voorhees Family Practice Associates, P.C.
• Voorhees Fire District
• Voorhees Medical Practice LLC
• Voorhees Neurology Care
• Voorhees NJ Endoscopy ASC LLC (The Endo Center at Voorhees)
• Voorhees Opco, LLC (Residence at Voorhees)
• Voorhees Pediatric Center Associates Limited Partnership Dba VPF

• Pediatrics Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2017; 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.