Provider Demographics
NPI:1134449184
Name:SA HEALTHCARE MANAGEMENT, LLC
Entity type:Organization
Organization Name:SA HEALTHCARE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-897-1204
Mailing Address - Street 1:145 ROUTE 46 W
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6830
Mailing Address - Country:US
Mailing Address - Phone:973-897-1204
Mailing Address - Fax:973-513-6081
Practice Address - Street 1:145 ROUTE 46 W
Practice Address - Street 2:SUITE 304
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6830
Practice Address - Country:US
Practice Address - Phone:973-897-1204
Practice Address - Fax:973-513-6081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-01
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty