MEDICARE: DR. MOHAMMAD A SARRAF M.D.

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	207RP1001X	Pulmonary Disease Physician	MA30954	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1K8793	OTHER	NJ	HEALTHNET
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P1550685	OTHER	NJ	OXFORD
4	0076563000	OTHER	NJ	AMERIHEALTH
5	442013675	OTHER	NJ	RAILROAD

General Provider Information

NPI Number	:	1689648735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD A SARRAF M.D.

Provider Business Mailing Address
First Line	:	1907 PARK AVE
Second Line	:	SUITE 202
City	:	SOUTH PLAINFIELD
State	:	NJ
Zip	:	07080-5530
Country	:	US
Telephone Number	:	908-561-1313
Fax Number	:	908-561-3917

Provider Business Practice Location Address
First Line	:	1907 PARK AVE
Second Line	:	SUITE 202
City	:	SOUTH PLAINFIELD
State	:	NJ
Zip	:	07080-5530
Country	:	US
Telephone Number	:	908-561-1313
Fax Number	:	908-561-3917

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	10/26/2010

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