Provider Demographics
NPI:1447279179
Name:SAXENA, PARUL (MD)
Entity type:Individual
Prefix:MRS
First Name:PARUL
Middle Name:
Last Name:SAXENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:427 GUY PARK AVE
Mailing Address - Street 2:ST. MARY'S HEALTHCARE; CORPORATE RESPONSIBILITY/LEGAL D
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-1054
Mailing Address - Country:US
Mailing Address - Phone:518-770-7518
Mailing Address - Fax:518-770-7570
Practice Address - Street 1:700 S. PERRY ST
Practice Address - Street 2:ST. MARY'S HOSPITAL FAM HLTH CNTR AT JOHNSTOWN PEDIATRI
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095
Practice Address - Country:US
Practice Address - Phone:518-762-3161
Practice Address - Fax:518-762-4902
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2013-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY183830208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY398798OtherMVP
NY000470630008OtherBSNENY
NY090602000068OtherFIDELIS
NY10118765OtherCDPHP
NY000000114401OtherGHI HMO
NY01349339Medicaid
NY0144337OtherGHI PPO
NY4322150OtherAETNA
NY8B3623OtherEMPIRE BCBS
NYJ400004284Medicare PIN