Provider Demographics
NPI:1336344498
Name:BHUTTA, SAIMA A (PA)
Entity Type:Individual
Prefix:
First Name:SAIMA
Middle Name:A
Last Name:BHUTTA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SAIMA
Other - Middle Name:
Other - Last Name:ABRAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 MICHAEL CT
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057
Mailing Address - Country:US
Mailing Address - Phone:856-222-1468
Mailing Address - Fax:856-778-5818
Practice Address - Street 1:640 N WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037
Practice Address - Country:US
Practice Address - Phone:609-567-9003
Practice Address - Fax:609-567-9269
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00140100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091258Medicaid
NJ091258Medicaid