Healthcare Provider Details
I. General information
NPI: 1841440377
Provider Name (Legal Business Name): BRYAN SAIA D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/20/2008
Last Update Date: 02/14/2024
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
243 HURFFVILLE CROSSKEYS RD STE 101
SEWELL NJ
08080-4011
US
IV. Provider business mailing address
120 WHITE HORSE PIKE STE 112
HADDON HEIGHTS NJ
08035-1994
US
V. Phone/Fax
- Phone: 856-582-2000
- Fax: 856-582-2061
- Phone: 856-547-0539
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 25MB09178700 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207UN0901X |
| Taxonomy | Nuclear Cardiology Physician |
| License Number | 25MB09178700 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: