Provider Demographics
NPI:1164463071
Name:NAHAR, SUDHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUDHA
Middle Name:
Last Name:NAHAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 WILLOW WOODS TRL
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5565
Mailing Address - Country:US
Mailing Address - Phone:732-873-1600
Mailing Address - Fax:732-873-1606
Practice Address - Street 1:17 CLYDE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5041
Practice Address - Country:US
Practice Address - Phone:732-873-1600
Practice Address - Fax:732-873-1606
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA070293207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9131001Medicaid
NJ070011RVNMedicare ID - Type UnspecifiedMEDICARE NUMBER
NJ9131001Medicaid
NJ070982Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER