Provider Demographics
NPI:1477654911
Name:SAHARIA, REETA (MD)
Entity Type:Individual
Prefix:DR
First Name:REETA
Middle Name:
Last Name:SAHARIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 MERRICK ROAD
Mailing Address - Street 2:202
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510
Mailing Address - Country:US
Mailing Address - Phone:516-223-9772
Mailing Address - Fax:516-223-3801
Practice Address - Street 1:865 MERRICK ROAD
Practice Address - Street 2:BALDWIN MEDICAL PLAZA #202
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510
Practice Address - Country:US
Practice Address - Phone:516-223-9772
Practice Address - Fax:516-223-3801
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138305208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY006560887Medicaid
28A831Medicare ID - Type Unspecified
NY006560887Medicaid