Provider Demographics
NPI:1821035411
Name:FAN, SARAH Y (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:Y
Last Name:FAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:375 MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2724
Mailing Address - Country:US
Mailing Address - Phone:973-731-9442
Mailing Address - Fax:973-731-2918
Practice Address - Street 1:653 WILLOW GROVE ST
Practice Address - Street 2:STE 1000
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1732
Practice Address - Country:US
Practice Address - Phone:908-852-9020
Practice Address - Fax:908-852-5056
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-09-03
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08829800207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology