Provider Demographics
NPI:1528851375
Name:SAIDJANOV, ABDURAUF
Entity type:Individual
Prefix:
First Name:ABDURAUF
Middle Name:
Last Name:SAIDJANOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 HOPKINS AVE
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5735
Mailing Address - Country:US
Mailing Address - Phone:267-235-4255
Mailing Address - Fax:
Practice Address - Street 1:743 HOPKINS AVE
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5735
Practice Address - Country:US
Practice Address - Phone:267-235-4255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-24
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA343900000X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1427854082Medicaid