Noushin Heidary MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

25MA98581800 Issued in NJ

Legal business name

NOUSHIN HEIDARY MD LLC

Practice address

290 S Livingston Ave
Livingston, NJ 07039-3931

Phone

(973) 740-0101

Fax

(973) 740-0103

NPI assigned

Oct 12, 2012

Organization subpart

No

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

Authorized official

Name

Noushin Heidary, MD

Title

Ceo

Phone

(973) 740-0101

Specialties & licenses 1

Addresses

Other names 1

• Dermatology and Laser Center of Northern New Jersey Doing business as

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1982956124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 S LIVINGSTON AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393931",
            "telephone_number": "973-740-0101",
            "fax_number": "973-740-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 S LIVINGSTON AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070393931",
            "telephone_number": "973-740-0101",
            "fax_number": "973-740-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOUSHIN HEIDARY MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "HEIDARY",
        "authorized_official_first_name": "NOUSHIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-740-0101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA98581800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology and Laser Center of Northern New Jersey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dermatology Physician in Livingston, NJ
• Providers in Livingston, NJ by specialty
• Dermatology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.