Healthcare Provider Details

I. General information

NPI: 1326737990
Provider Name (Legal Business Name): SAROSH ALAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 E 29TH ST
BAYONNE NJ
07002-4695
US

IV. Provider business mailing address

29 COLONIAL DR
BAYONNE NJ
07002-2216
US

V. Phone/Fax

Practice location:
  • Phone: 201-858-6593
  • Fax:
Mailing address:
  • Phone: 609-648-1319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101290538
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: