Healthcare Provider Details

I. General information

NPI: 1336098417
Provider Name (Legal Business Name): PEAR SUITE PROVIDER GROUP NJ, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 BEAR TAVERN RD
EWING NJ
08628-1021
US

IV. Provider business mailing address

820 BEAR TAVERN RD
EWING NJ
08628-1021
US

V. Phone/Fax

Practice location:
  • Phone: 213-277-7340
  • Fax:
Mailing address:
  • Phone: 213-277-7340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAHIL VAGHA
Title or Position: OWNER
Credential: DO
Phone: 213-277-7340