Healthcare Provider Details

I. General information

NPI: 1740721257
Provider Name (Legal Business Name): SADDLE RIVER HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 02/18/2024
Certification Date: 02/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 KINDERKAMACK RD
ORADELL NJ
07649-1600
US

IV. Provider business mailing address

PO BOX 656
SADDLE RIVER NJ
07458-0656
US

V. Phone/Fax

Practice location:
  • Phone: 201-367-2273
  • Fax:
Mailing address:
  • Phone: 201-560-7611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: YASMEEN KHAN
Title or Position: MD
Credential: MD
Phone: 201-560-7611