Provider Demographics
NPI:1568415990
Name:JAIN, SAPNA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAPNA
Middle Name:
Last Name:JAIN
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 1:1024 PARK AVE
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060
Mailing Address - Country:US
Mailing Address - Phone:908-222-8400
Mailing Address - Fax:908-222-8402
Practice Address - Street 1:805 INMAN AVE
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067
Practice Address - Country:US
Practice Address - Phone:732-340-0007
Practice Address - Fax:732-340-0777
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07300600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0146757Medicaid
NJ067475XEDMedicare PIN