Provider Demographics
NPI:1295836294
Name:SAKSENA, SANJEEV (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJEEV
Middle Name:
Last Name:SAKSENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 WASHINGTON VALLEY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059
Mailing Address - Country:US
Mailing Address - Phone:732-302-9988
Mailing Address - Fax:732-302-9911
Practice Address - Street 1:161 WASHINGTON VALLEY RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-7176
Practice Address - Country:US
Practice Address - Phone:732-302-9988
Practice Address - Fax:732-302-9911
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03791100207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0569402Medicaid
NJ3010524OtherAETNA
NJP2718668OtherOXFORD
NJP2718668OtherOXFORD
C58460Medicare UPIN
047641QX5Medicare PIN