MEDICARE: DR. SAPNA JAIN MD

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	207R00000X	Internal Medicine Physician	25MA07300600	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568415990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAPNA JAIN MD

Provider Business Mailing Address
First Line	:	1024 PARK AVE
Second Line	:	SUITE 6A
City	:	PLAINFIELD
State	:	NJ
Zip	:	07060
Country	:	US
Telephone Number	:	908-222-8400
Fax Number	:	908-222-8402

Provider Business Practice Location Address
First Line	:	805 INMAN AVE
Second Line	:
City	:	COLONIA
State	:	NJ
Zip	:	07067
Country	:	US
Telephone Number	:	732-340-0007
Fax Number	:	732-340-0777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	11/11/2010

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