Provider Demographics
NPI:1629249537
Name:NIRMALA SARAF, M.D., P.A.
Entity Type:Organization
Organization Name:NIRMALA SARAF, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:NIRMALA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:973-395-1500
Mailing Address - Street 1:310 CENTRAL AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-2835
Mailing Address - Country:US
Mailing Address - Phone:973-395-1500
Mailing Address - Fax:
Practice Address - Street 1:310 CENTRAL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2835
Practice Address - Country:US
Practice Address - Phone:973-395-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2010-09-13
Deactivation Date:2008-08-11
Deactivation Code:
Reactivation Date:2010-09-10
Provider Licenses
StateLicense IDTaxonomies
NJMA064416207R00000X
207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7018002Medicaid
G42558Medicare UPIN
894076Medicare PIN