Healthcare Provider Details

I. General information

NPI: 1255404927
Provider Name (Legal Business Name): SASAN MICHAEL PARANGI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MICHAEL SASAN PARANGI MD

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 04/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 YALE CT
PARAMUS NJ
07652-5517
US

IV. Provider business mailing address

9 YALE CT
PARAMUS NJ
07652-5517
US

V. Phone/Fax

Practice location:
  • Phone: 201-265-7564
  • Fax: 201-265-6991
Mailing address:
  • Phone: 201-265-7564
  • Fax: 201-265-6991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA58746
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier5344204
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: