Provider Demographics
NPI:1780831867
Name:DAS, SUMON KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SUMON
Middle Name:KUMAR
Last Name:DAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:201 LYONS AVE
Mailing Address - Street 2:STE C5
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2027
Mailing Address - Country:US
Mailing Address - Phone:973-926-8267
Mailing Address - Fax:973-926-6452
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:STE C5
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-8267
Practice Address - Fax:973-926-6452
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2022-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4382972080P0203X
NY2460382080P0203X
NJMA085365002080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0194476Medicaid
NJ179222B7AMedicare PIN