Provider Demographics
NPI:1952706681
Name:SHAHID MIAN MD PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:SHAHID MIAN MD PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:W
Authorized Official - Last Name:MIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-734-3344
Mailing Address - Street 1:893 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0368
Mailing Address - Country:US
Mailing Address - Phone:212-734-3344
Mailing Address - Fax:
Practice Address - Street 1:444 MARKET ST
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5996
Practice Address - Country:US
Practice Address - Phone:201-853-2000
Practice Address - Fax:212-734-4037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08858900207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty