=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548331671
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SADHANA PARI M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/12/2006
-----------------------------------------------------
Last Update Date | 02/23/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 49 VERONICA AVE SUITE # 101
-----------------------------------------------------
City | SOMERSET
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08873-6802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-247-3434
-----------------------------------------------------
Fax | 732-247-1815
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9 PROVIDENCE DR
-----------------------------------------------------
City | PRINCETON JCT
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08550-2154
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-889-4249
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 25MA08129100
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------