Provider Demographics
NPI:1184652109
Name:SUNSHINE PEDIATRICS, LLC
Entity Type:Organization
Organization Name:SUNSHINE PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMARAO
Authorized Official - Middle Name:S
Authorized Official - Last Name:GAJULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-758-5437
Mailing Address - Street 1:504 MONMOUTH RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CLARKSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-1226
Mailing Address - Country:US
Mailing Address - Phone:609-208-0570
Mailing Address - Fax:609-208-0574
Practice Address - Street 1:504 MONMOUTH RD
Practice Address - Street 2:SUITE 7
Practice Address - City:CLARKSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08510-1226
Practice Address - Country:US
Practice Address - Phone:609-208-0570
Practice Address - Fax:609-208-0574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty