Provider Demographics
NPI:1063672376
Name:SAHANI, HERNEET K (MD)
Entity Type:Individual
Prefix:
First Name:HERNEET
Middle Name:K
Last Name:SAHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HERNEET
Other - Middle Name:
Other - Last Name:SAHANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PA
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-0023
Mailing Address - Country:US
Mailing Address - Phone:973-497-2420
Mailing Address - Fax:973-497-2421
Practice Address - Street 1:539 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-1385
Practice Address - Country:US
Practice Address - Phone:973-497-2420
Practice Address - Fax:973-497-2421
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 61803207RE0101X
NJMA061803207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7225806Medicaid
SA 722637Medicare PIN
NJ7225806Medicaid