Healthcare Provider Details

I. General information

NPI: 1942407861
Provider Name (Legal Business Name): SATYA D NARISETY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 EAGLE ROCK AVE STE G3
WEST ORANGE NJ
07052-2994
US

IV. Provider business mailing address

622 EAGLE ROCK AVE STE G3
WEST ORANGE NJ
07052-2994
US

V. Phone/Fax

Practice location:
  • Phone: 973-424-1300
  • Fax: 972-424-1722
Mailing address:
  • Phone: 908-295-7488
  • Fax: 972-424-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number245224
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA08997400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number245224
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number25MA08997400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: