Basic Information
| Provider Information | |||||||||
| NPI: | 1508864844 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAYAN | ||||||||
| FirstName: | AHMET | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9149 ESTATE THOMAS | ||||||||
| Address2: | STE 104 | ||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008023132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407142845 | ||||||||
| FaxNumber: | 3407142843 | ||||||||
| Practice Location | |||||||||
| Address1: | 9149 ESTATE THOMAS STE 104 | ||||||||
| Address2: | |||||||||
| City: | ST THOMAS | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008023132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3407142845 | ||||||||
| FaxNumber: | 3407142843 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2005 | ||||||||
| LastUpdateDate: | 08/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | MED-PHYS-LIC-114038 | MT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 25MA07723600 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | P3418620 | 01 | NJ | OXFORD | OTHER | 7452582 | 01 | NJ | AETNA | OTHER | P00138745 | 01 | NJ | RAILROAD MEDICARE | OTHER | 2112579 | 01 | NJ | UNITED HEALTHCARE | OTHER | 3559706 | 01 | NJ | US HEALTHCARE | OTHER | 588P5 | 01 | NJ | EMPIRE BLUE CROSS | OTHER | 0037851 | 05 | NJ | MEDICAID |