Provider Demographics
NPI:1558534966
Name:SINOPOLI, WALTER ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:ANTHONY
Last Name:SINOPOLI
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:PO BOX 800
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-0800
Mailing Address - Country:US
Mailing Address - Phone:908-330-9966
Mailing Address - Fax:
Practice Address - Street 1:9 N ROHALLION DR
Practice Address - Street 2:
Practice Address - City:RUMSON
Practice Address - State:NJ
Practice Address - Zip Code:07760-1218
Practice Address - Country:US
Practice Address - Phone:908-330-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03636300207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4866207Medicaid
NJ4866207Medicaid