Provider Demographics
NPI:1912971730
Name:JAIN, SNEH (MD)
Entity Type:Individual
Prefix:MRS
First Name:SNEH
Middle Name:
Last Name:JAIN
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 1:1415 MARLTON PIKE E STE LL5
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2229
Mailing Address - Country:US
Mailing Address - Phone:856-285-7200
Mailing Address - Fax:856-285-7201
Practice Address - Street 1:900 ROUTE 168 STE A6
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-3207
Practice Address - Country:US
Practice Address - Phone:856-232-6500
Practice Address - Fax:856-232-0022
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37110207R00000X
NJ25MA03711000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0455091OtherMEDICAID GROUP
NJ381020OtherMEDICARE GROUP
NJ381020OtherMEDICARE GROUP
NJ2237202Medicaid