Healthcare Provider Details

I. General information

NPI: 1629288360
Provider Name (Legal Business Name): VINA SARAIYA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 ROUTE 46 ATRIUM PROFFESSIONAL CENTER SUITE 202
MINE HILL NJ
07803
US

IV. Provider business mailing address

1 CRANE DR
PINE BROOK NJ
07058-9500
US

V. Phone/Fax

Practice location:
  • Phone: 973-989-5185
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number25MA03838500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: