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General NPI Number Information
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NPI Number | 1124817648
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Entity Type | Organization
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Legal Business Name | BLUE ONYX MEDICAL LLC
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 109 W MAIN ST
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City | DENVILLE
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State | NJ
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Zip | 07834-1600
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Country | US
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Telephone | 973-954-9401
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Fax |
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Provider Business Mailing Address
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Address Line | 11166 FAIRFAX BLVD STE 500
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City | FAIRFAX
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State | VA
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Zip | 22030-5017
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Country | US
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Telephone | 973-954-9401
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Fax |
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Authorized Official
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Title or Position | MD/CEO
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Name | SUNIL SAXENA
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Credential | MD
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Telephone | 973-954-9401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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