Healthcare Provider Details
I. General information
NPI: 1265665194
Provider Name (Legal Business Name): SATYANARAYAN HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2009
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 EHEL ROAD SUITE 106 C
EDISON NJ
08817-2838
US
IV. Provider business mailing address
1 ETHEL RD STE 106C
EDISON NJ
08817-2838
US
V. Phone/Fax
- Phone: 908-769-5100
- Fax: 908-769-5104
- Phone: 908-769-5100
- Fax: 908-769-5104
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | 12014 |
| License Number State | NJ |
VIII. Authorized Official
Name: MR.
TEJAS
PATEL
Title or Position: MEMBER
Credential: L.N.H.A.
Phone: 908-769-5100