Provider Demographics
NPI:1700864386
Name:SAXENA, PRIYA
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:SAXENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6149 SALTSBURG RD
Mailing Address - Street 2:PENN COMMONS BUILDING
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-3542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6149 SALTSBURG RD
Practice Address - Street 2:PENN COMMONS BUILDING
Practice Address - City:VERONA
Practice Address - State:PA
Practice Address - Zip Code:15147-3542
Practice Address - Country:US
Practice Address - Phone:412-712-1077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427748207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015174970002Medicaid
PA1015174970002Medicaid
PAP00466743Medicare PIN
PA097297R7RMedicare PIN