Provider Demographics
NPI:1649211921
Name:SABNANI, INDU (MD, FACP)
Entity Type:Individual
Prefix:DR
First Name:INDU
Middle Name:
Last Name:SABNANI
Suffix:
Gender:F
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 MILLBURN AVE
Mailing Address - Street 2:SUITE C11
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3725
Mailing Address - Country:US
Mailing Address - Phone:973-762-7676
Mailing Address - Fax:973-762-7677
Practice Address - Street 1:2130 MILLBURN AVE
Practice Address - Street 2:SUITE C11
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3725
Practice Address - Country:US
Practice Address - Phone:973-762-7676
Practice Address - Fax:973-762-7677
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA049357207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223680355OtherTAX ID
NJ1536605Medicaid
NJ610296Medicare ID - Type UnspecifiedMEDICARE NUMBER
NJ1536605Medicaid