Healthcare Provider Details

I. General information

NPI: 1447279179
Provider Name (Legal Business Name): PARUL SAXENA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S. PERRY ST ST. MARY'S HOSPITAL FAM HLTH CNTR AT JOHNSTOWN PEDIATRI
JOHNSTOWN NY
12095
US

IV. Provider business mailing address

427 GUY PARK AVE ST. MARY'S HEALTHCARE; CORPORATE RESPONSIBILITY/LEGAL D
AMSTERDAM NY
12010-1054
US

V. Phone/Fax

Practice location:
  • Phone: 518-762-3161
  • Fax: 518-762-4902
Mailing address:
  • Phone: 518-770-7518
  • Fax: 518-770-7570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number183830
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: