Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 25MA03618500 | NJ |
NPI | 1205812005 |
---|---|
Provider Name | Dr. Saad A Saad |
First Address | Eatontown, NJ 07724-1277 |
Second Address | Eatontown, NJ 07724-1277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 29/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C63028 | (02) | NJ |