Provider Demographics
NPI:1710069174
Name:SAFARYN, JOHN E (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:SAFARYN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST STE SW200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:856-356-4710
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER ANESTHESIA ASSOCIATES
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA06728000208VP0000X
NJMA67280207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2566131OtherUNITED HEALTHCARE
NJ7666501Medicaid
NJOXFORDOtherP2021692
NJ0490797000OtherAMERIHEALTH/KEYSTONE/IBC
NJ1170553OtherHORIZON NJ HEALTH
NJ000719632OtherAMERIHEALTH PPO/ PA BS
NJ010003812OtherAMERICHOICE
NJ1085501OtherHORIZON NJ HEALTH
NJ30441OtherUNIVERSITY HEALTH PLAN
NJ010003812OtherAMERICHOICE
NJ2566131OtherUNITED HEALTHCARE
NJ017284 DLFMedicare PIN