Provider Demographics
NPI:1629190939
Name:ALLEN N. SAPADIN, M.D., LLC
Entity Type:Organization
Organization Name:ALLEN N. SAPADIN, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:SAPADIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-525-0057
Mailing Address - Street 1:280 ARCH RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4401
Mailing Address - Country:US
Mailing Address - Phone:201-816-9066
Mailing Address - Fax:
Practice Address - Street 1:370 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1413
Practice Address - Country:US
Practice Address - Phone:201-525-0057
Practice Address - Fax:201-525-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG22383Medicare UPIN
NJ071717Medicare PIN