Provider Demographics
NPI:1700182151
Name:NAGORI, SAYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAYA
Middle Name:
Last Name:NAGORI
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 1:12150 ANNAPOLIS RD STE 111
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9183
Mailing Address - Country:US
Mailing Address - Phone:301-779-0844
Mailing Address - Fax:301-779-0744
Practice Address - Street 1:7305 BALTIMORE AVE STE 101
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740
Practice Address - Country:US
Practice Address - Phone:301-779-0844
Practice Address - Fax:301-779-0744
Is Sole Proprietor?:No
Enumeration Date:2011-02-02
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0084815207W00000X
MI4301102389207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD556025000Medicaid