Healthcare Provider Details

I. General information

NPI: 1588456032
Provider Name (Legal Business Name): RADHA K. SAHA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1444 OLMSTEAD AVENUE
BRONX NY
10462
US

IV. Provider business mailing address

196 DOUGLAS AVE
YONKERS NY
10703-1917
US

V. Phone/Fax

Practice location:
  • Phone: 347-261-6862
  • Fax:
Mailing address:
  • Phone: 347-261-6862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberF356715
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: