Provider Demographics
NPI:1487649257
Name:JAIN, SUNITA K (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNITA
Middle Name:K
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1 HEALTHY WAY
Mailing Address - Street 2:ATTN: PHYSICIAN BILLING
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1551
Mailing Address - Country:US
Mailing Address - Phone:516-255-1600
Mailing Address - Fax:516-255-4672
Practice Address - Street 1:196 MERRICK RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-1420
Practice Address - Country:US
Practice Address - Phone:516-255-8400
Practice Address - Fax:516-255-8453
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY209803207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1000027876OtherAFFINITY
NY3C3275OtherHEALTHNET
NY000000072442OtherGHI HMO
NY2128487OtherUNITED HEALTHCARE
NY01919460Medicaid
NY040426009475OtherFIDELIS
NY5997924OtherGHI PPO
NY135337OtherAETNA HMO
NY5090A1OtherBCBS
NY5841688OtherAETNA PPO
NY209803OtherHIP
NY3134504OtherCIGNA
NYP2471796OtherOXFORD
NY5841688OtherAETNA PPO
NY1000027876OtherAFFINITY