Healthcare Provider Details

I. General information

NPI: 1295000180
Provider Name (Legal Business Name): DR. SAIMA MIAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 03/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 36TH ST
UNION CITY NJ
07087-4712
US

IV. Provider business mailing address

402 36TH ST
UNION CITY NJ
07087-4712
US

V. Phone/Fax

Practice location:
  • Phone: 201-866-3299
  • Fax: 201-866-3396
Mailing address:
  • Phone: 201-866-3299
  • Fax: 201-866-3396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number21485
License Number StateNJ

VIII. Authorized Official

Name: DR. SAIMA MIAN
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 201-866-3299