Healthcare Provider Details

I. General information

NPI: 1952295156
Provider Name (Legal Business Name): SAEID VAHIDI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

758 ROUTE 18 STE 110
EAST BRUNSWICK NJ
08816-4910
US

IV. Provider business mailing address

758 ROUTE 18 STE 110
EAST BRUNSWICK NJ
08816-4910
US

V. Phone/Fax

Practice location:
  • Phone: 732-743-5169
  • Fax:
Mailing address:
  • Phone: 732-743-5169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL07282100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: