Provider Demographics
NPI:1841245230
Name:BERY, SUMITA (MD)
Entity Type:Individual
Prefix:
First Name:SUMITA
Middle Name:
Last Name:BERY
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 29
Mailing Address - Street 2:HUNTERDON ANESTHESIA ASSOCIATES
Mailing Address - City:OLDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08858-0029
Mailing Address - Country:US
Mailing Address - Phone:908-534-0792
Mailing Address - Fax:908-236-0637
Practice Address - Street 1:2100 WESCOTT DRIVE
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822
Practice Address - Country:US
Practice Address - Phone:908-788-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07080800207L00000X
NJMA70808208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8548609Medicaid
NJ223586664OtherBCBSNJ
NJ223586664OtherCHAMPUS-TRICARE
NJ223586664OtherBCBSNJ
H44950Medicare UPIN