Provider Demographics
NPI:1316388234
Name:PATHAK, SANKALP (MD)
Entity Type:Individual
Prefix:DR
First Name:SANKALP
Middle Name:
Last Name:PATHAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:65 RIDGEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927-1313
Mailing Address - Country:US
Mailing Address - Phone:973-401-1100
Mailing Address - Fax:973-401-1201
Practice Address - Street 1:59-61 HIGH STREET
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860
Practice Address - Country:US
Practice Address - Phone:973-300-1302
Practice Address - Fax:973-300-1201
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA10159100207RI0011X
DEC1-0013560207RI0011X, 207RI0011X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology