Provider Demographics
NPI:1932393147
Name:SANA, WAJEEH (MD)
Entity Type:Individual
Prefix:DR
First Name:WAJEEH
Middle Name:
Last Name:SANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4413 WINDING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-8347
Mailing Address - Country:US
Mailing Address - Phone:419-508-0124
Mailing Address - Fax:419-508-0124
Practice Address - Street 1:4413 WINDING CREEK RD
Practice Address - Street 2:
Practice Address - City:MANLIUS
Practice Address - State:NY
Practice Address - Zip Code:13104-8347
Practice Address - Country:US
Practice Address - Phone:419-508-0124
Practice Address - Fax:419-508-0124
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13412207Q00000X
NY246331207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03040131Medicaid
NYJ400003789Medicare PIN