MEDICARE: DR. SANA H OBAID 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	207VG0400X	Gynecology Physician	25MA08506600	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25MA08506600	OTHER	NJ	MEDICAL LICENSE

General Provider Information

NPI Number	:	1619106671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANA H OBAID MD

Provider Business Mailing Address
First Line	:	107 TIMBERLINE DR
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-5558
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 MCBRIDE AVE
Second Line	:	SUITE C
City	:	WOODLAND PARK
State	:	NJ
Zip	:	07424-3806
Country	:	US
Telephone Number	:	973-785-8400
Fax Number	:	973-785-8402

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

Provider Enumeration Date	:	07/10/2009
Last Update Date	:	05/05/2014

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