Provider Demographics
NPI:1952316531
Name:PACHECO-SMITH, SARIYA A (MD)
Entity Type:Individual
Prefix:
First Name:SARIYA
Middle Name:A
Last Name:PACHECO-SMITH
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 1:321 N WARREN ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4741
Mailing Address - Country:US
Mailing Address - Phone:609-278-5900
Mailing Address - Fax:609-695-3532
Practice Address - Street 1:321 N WARREN ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4741
Practice Address - Country:US
Practice Address - Phone:609-278-5900
Practice Address - Fax:609-695-3532
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07001100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I18431Medicare UPIN