Provider Demographics
NPI:1861553638
Name:SHAMA, SARA (RD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SHAMA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:HALIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 STELTON RD
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2639
Mailing Address - Country:US
Mailing Address - Phone:732-395-1282
Mailing Address - Fax:732-424-0443
Practice Address - Street 1:24 STELTON RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-2639
Practice Address - Country:US
Practice Address - Phone:732-395-1282
Practice Address - Fax:732-658-6392
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ954704133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ200397267OtherHORIZON BCBS-NJ
NJ7654551OtherAETNA
NJ200397267OtherCIGNA
NJP3699965OtherOXFORD
NJ2634157OtherUNITED HEALTHCARE
NJP3686480OtherOXFORD