Provider Demographics
NPI:1073601225
Name:M.A. SARRAF, M.D., P.A.
Entity Type:Organization
Organization Name:M.A. SARRAF, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:SARRAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-561-1313
Mailing Address - Street 1:1907 PARK AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5530
Mailing Address - Country:US
Mailing Address - Phone:908-561-1313
Mailing Address - Fax:908-561-3917
Practice Address - Street 1:1907 PARK AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5530
Practice Address - Country:US
Practice Address - Phone:908-561-1313
Practice Address - Fax:908-561-3917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2908701Medicaid
NJ2371892002OtherAMERIHEALTH GROUP NUMBER
NJDB1885OtherRAILROAD GROUP NUMBER
NJ2371892002OtherAMERIHEALTH GROUP NUMBER