Provider Demographics
NPI:1770673758
Name:JALIAWALA, SAHER (MD)
Entity Type:Individual
Prefix:DR
First Name:SAHER
Middle Name:
Last Name:JALIAWALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 MIDDLETOWN BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1897
Mailing Address - Country:US
Mailing Address - Phone:215-269-3330
Mailing Address - Fax:
Practice Address - Street 1:272A HOBART ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4311
Practice Address - Country:US
Practice Address - Phone:732-293-0135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08090500207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0097811Medicaid
NJ8751404Medicaid
NJ063701Medicare ID - Type UnspecifiedGROUP