Provider Demographics
NPI:1134186489
Name:PARHAR, AVTAR S (MD FCCP)
Entity type:Individual
Prefix:
First Name:AVTAR
Middle Name:S
Last Name:PARHAR
Suffix:
Gender:M
Credentials:MD FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 288
Mailing Address - Street 2:
Mailing Address - City:WICKATUNK
Mailing Address - State:NJ
Mailing Address - Zip Code:07765-0288
Mailing Address - Country:US
Mailing Address - Phone:732-264-7970
Mailing Address - Fax:732-264-8858
Practice Address - Street 1:721 N BEERS ST
Practice Address - Street 2:STE 2G
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1518
Practice Address - Country:US
Practice Address - Phone:732-264-7970
Practice Address - Fax:732-264-8858
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA58321207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
896983Medicare ID - Type Unspecified
F80682Medicare UPIN