1578558748 NPI number — DR. RAMESH M SARVAIYA M.D. ANESTHESIOLOGIS

Table of content: DR. RAMESH M SARVAIYA M.D. ANESTHESIOLOGIS (NPI 1578558748)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578558748 NPI number — DR. RAMESH M SARVAIYA M.D. ANESTHESIOLOGIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SARVAIYA
Provider First Name:
RAMESH
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D. ANESTHESIOLOGIS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578558748
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
509 N BROAD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODBURY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08096-1617
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-845-0100
Provider Business Mailing Address Fax Number:
856-848-7023

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17 W RED BANK AVE
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
WOODBURY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08096-1630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-848-4464
Provider Business Practice Location Address Fax Number:
856-848-7023
Provider Enumeration Date:
09/14/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 25MA07343200 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0026701 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: D08111300 . This is a "CDS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".