Provider Demographics
NPI:1437154069
Name:MANN, SUNITA SINGH (MD)
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:SINGH
Last Name:MANN
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:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-0397
Mailing Address - Country:US
Mailing Address - Phone:732-849-0077
Mailing Address - Fax:732-849-0015
Practice Address - Street 1:1608 ROUTE 88 W
Practice Address - Street 2:STE 102
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3009
Practice Address - Country:US
Practice Address - Phone:732-849-0077
Practice Address - Fax:732-849-0015
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA63310174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8213305Medicaid
NJH17716Medicare UPIN