Basic Information
| Provider Information | |||||||||
| NPI: | 1467436170 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AFRIDI | ||||||||
| FirstName: | SHARIQ | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1374 WHITEHORSE HAMILTON SQUARE RD | ||||||||
| Address2: | |||||||||
| City: | HAMILTON SQ | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086903701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095861319 | ||||||||
| FaxNumber: | 6095861468 | ||||||||
| Practice Location | |||||||||
| Address1: | 1374 WHITEHORSE HAMILTON SQUARE RD | ||||||||
| Address2: | |||||||||
| City: | HAMILTON SQ | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086903701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095861319 | ||||||||
| FaxNumber: | 6095861468 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2005 | ||||||||
| LastUpdateDate: | 04/11/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 25MA06201100 | NJ | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 1323334 | 01 | NJ | FIRSTHEALTH | OTHER | 502170 | 01 | NJ | AETNA HMO | OTHER | 84663 | 01 | NH | AMERICAID | OTHER | 010002881-00 | 01 | NJ | AMERICHOICE | OTHER | 147288 | 01 | NJ | DEVON | OTHER | 222233588 | 01 | NJ | HORIZON BC/BS | OTHER | 4319169 | 01 | NJ | AETNA PPO | OTHER | 0179074-004 | 01 | NJ | CIGNA | OTHER | 1K71161 | 01 | NJ | HEALTHNET | OTHER | 58465 | 01 | NH | LOCAL | OTHER | 6512003 | 05 | NJ | MEDICAID | 0000653740001 | 01 | NH | ONE HEALTH PLAN | OTHER | 1014252 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 1755890 | 01 | NJ | UHC | OTHER | 3U324 | 01 | NJ | EMPIRE HEALTH CARE | OTHER | 636104 | 01 | NJ | AMERIHEALTH PPO | OTHER | P768331 | 01 | NJ | OXFORD | OTHER | 0778149000 | 01 | NH | AMERIHEALTH | OTHER |