Provider Demographics
NPI:1043324668
Name:SASTRASINH, SITHIPORN (MD)
Entity Type:Individual
Prefix:DR
First Name:SITHIPORN
Middle Name:
Last Name:SASTRASINH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SENEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924
Mailing Address - Country:US
Mailing Address - Phone:908-221-1198
Mailing Address - Fax:
Practice Address - Street 1:385 TREMONT AVE.
Practice Address - Street 2:MEDICAL SERVICE (111)
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018
Practice Address - Country:US
Practice Address - Phone:973-395-7771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04348000207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology