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General NPI Number Information
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NPI Number | 1518006675
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Entity Type | Individual
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Provider Name | KATHLEEN ANN SARADARIAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 22 WANTAGE AVE UNIT 3
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City | BRANCHVILLE
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State | NJ
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Zip | 07826-5640
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Country | US
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Telephone | 973-948-4232
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Fax | 973-948-6712
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Provider Business Mailing Address
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Address Line | PO BOX 2457 (22 WANTAGE AVE., UNIT 3)
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City | BRANCHVILLE
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State | NJ
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Zip | 07826-2457
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Country | US
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Telephone | 973-948-4232
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Fax | 973-948-6712
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA05277900
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License Number State | NJ
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