Provider Demographics
NPI:1730199696
Name:MINTZ, SHARI N (MD)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:N
Last Name:MINTZ
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1 INDIAN RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2051
Mailing Address - Country:US
Mailing Address - Phone:973-625-2121
Mailing Address - Fax:973-625-8270
Practice Address - Street 1:1 INDIAN RD
Practice Address - Street 2:SUITE 8
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2051
Practice Address - Country:US
Practice Address - Phone:973-625-2121
Practice Address - Fax:973-625-8270
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07699700207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI19908Medicare UPIN
NJ084747VT1Medicare PIN