Provider Demographics
NPI:1619913605
Name:SANJAY, PRIYANKA (MD)
Entity Type:Individual
Prefix:DR
First Name:PRIYANKA
Middle Name:
Last Name:SANJAY
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 1:216 STELTON RD
Mailing Address - Street 2:UNIT B3
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3284
Mailing Address - Country:US
Mailing Address - Phone:732-662-9959
Mailing Address - Fax:
Practice Address - Street 1:216 STELTON RD
Practice Address - Street 2:UNIT B3
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3284
Practice Address - Country:US
Practice Address - Phone:732-662-9959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA077958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0098612Medicaid
NJ0098612Medicaid
NJL25257Medicare UPIN