Provider Demographics
NPI:1639747447
Name:RELIANT ENDOCRINOLOGY, LLC
Entity Type:Organization
Organization Name:RELIANT ENDOCRINOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUHALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKERYWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-255-1333
Mailing Address - Street 1:637 WYCKOFF AVE STE 389
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-1438
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:551-587-7756
Practice Address - Street 1:385 CLINTON AVE STE 3
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-1934
Practice Address - Country:US
Practice Address - Phone:914-255-1333
Practice Address - Fax:551-587-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty