Provider Demographics
NPI:1497744619
Name:SUN, ANDREW NICHOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:NICHOLAS
Last Name:SUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 WHITE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1150
Mailing Address - Country:US
Mailing Address - Phone:732-741-3331
Mailing Address - Fax:732-741-5119
Practice Address - Street 1:200 WHITE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1150
Practice Address - Country:US
Practice Address - Phone:732-741-3331
Practice Address - Fax:732-741-5119
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2023-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA67538207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7980001Medicaid
NJ7980001Medicaid
H22822Medicare UPIN