Provider Demographics
NPI:1629195748
Name:AKHTAR, REZA YASIN (MD)
Entity type:Individual
Prefix:
First Name:REZA
Middle Name:YASIN
Last Name:AKHTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1907 HWY 35
Mailing Address - Street 2:SUITE #1
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2765
Mailing Address - Country:US
Mailing Address - Phone:732-517-0060
Mailing Address - Fax:732-548-7408
Practice Address - Street 1:1907 HWY 35
Practice Address - Street 2:SUITE #1
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2765
Practice Address - Country:US
Practice Address - Phone:732-517-0060
Practice Address - Fax:732-548-7408
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08917800207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine