Provider Demographics
NPI:1235169558
Name:SAPRU, SUNIL (MD)
Entity Type:Individual
Prefix:
First Name:SUNIL
Middle Name:
Last Name:SAPRU
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 OLD SHORT HILLS ROAD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2507
Mailing Address - Country:US
Mailing Address - Phone:973-322-6256
Mailing Address - Fax:973-322-6241
Practice Address - Street 1:101 OLD SHORT HILLS ROAD
Practice Address - Street 2:SUITE 106
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2507
Practice Address - Country:US
Practice Address - Phone:973-322-6256
Practice Address - Fax:973-322-6241
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07568300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH96524Medicare UPIN