MEDICARE: MERCER KIDNEY & HYPERTENSION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	25MB08244500	NJ

General Provider Information

NPI Number	:	1275729980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCER KIDNEY & HYPERTENSION, LLC

Provider Business Mailing Address
First Line	:	601 EWING STREET
Second Line	:	SUITE C-7
City	:	PRINCETON
State	:	NJ
Zip	:	08540-2756
Country	:	US
Telephone Number	:	609-688-0710
Fax Number	:	609-921-0869

Provider Business Practice Location Address
First Line	:	601 EWING STREET
Second Line	:	SUITE C-7
City	:	PRINCETON
State	:	NJ
Zip	:	08540-2756
Country	:	US
Telephone Number	:	609-688-0710
Fax Number	:	609-921-0869

Authorized Official
Title or Position	:	OWNER
Name	:	DR. APARNA SAHOO
Credential	:	DO
Telephone Number	:	732-735-0746

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	01/24/2008

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