Provider Demographics
NPI:1508892845
Name:JAIN-BHALODIA, SAPNA (DO)
Entity Type:Individual
Prefix:DR
First Name:SAPNA
Middle Name:
Last Name:JAIN-BHALODIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 MICHAEL CT
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-2154
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1613 ROUTE 38
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-2921
Practice Address - Country:US
Practice Address - Phone:609-261-3716
Practice Address - Fax:609-261-5507
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06858500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8937303Medicaid
NJ045275R63Medicare PIN
NJ8937303Medicaid
NJ045275YBAWMedicare PIN
NJ045275DPTMedicare ID - Type Unspecified