Provider Demographics
NPI:1669676375
Name:SUNKAVALLI, ANUPAMA (MD)
Entity Type:Individual
Prefix:
First Name:ANUPAMA
Middle Name:
Last Name:SUNKAVALLI
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 1:19 TREVOR PL
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-9702
Mailing Address - Country:US
Mailing Address - Phone:732-566-5395
Mailing Address - Fax:
Practice Address - Street 1:19 TREVOR PL
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-9702
Practice Address - Country:US
Practice Address - Phone:732-566-5395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08219500207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology