Basic Information
| Provider Information | |||||||||
| NPI: | 1962659193 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SARAF | ||||||||
| FirstName: | SAJID | ||||||||
| MiddleName: | Y | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 NIANTIC RD | ||||||||
| Address2: | |||||||||
| City: | SHARON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020672962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017293481 | ||||||||
| FaxNumber: | 4017292721 | ||||||||
| Practice Location | |||||||||
| Address1: | 455 TOLL GATE RD | ||||||||
| Address2: | |||||||||
| City: | WARWICK | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028862759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017377000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2008 | ||||||||
| LastUpdateDate: | 07/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD13591 | RI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | SS84948 | 05 | RI | MEDICAID | 002175901 | 01 | RI | MEDICARE PTAN | OTHER | 110089214A | 05 | MA | MEDICAID |