Provider Demographics
NPI:1609973346
Name:UMAKANTHAN, SUGANTHINI (MD)
Entity Type:Individual
Prefix:DR
First Name:SUGANTHINI
Middle Name:
Last Name:UMAKANTHAN
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 3587
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08543-3587
Mailing Address - Country:US
Mailing Address - Phone:201-512-9494
Mailing Address - Fax:
Practice Address - Street 1:7500 K JOHNSON BLVD
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-2242
Practice Address - Country:US
Practice Address - Phone:609-599-5433
Practice Address - Fax:609-599-6203
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA066415174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ002549Medicare UPIN
NJG60345Medicare UPIN