Provider Demographics
NPI:1912011883
Name:SINHA, SUDIR K (MD)
Entity Type:Individual
Prefix:
First Name:SUDIR
Middle Name:K
Last Name:SINHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 OLD HOOK RD
Mailing Address - Street 2:SUITE #105
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3200
Mailing Address - Country:US
Mailing Address - Phone:201-599-8440
Mailing Address - Fax:201-599-8427
Practice Address - Street 1:333 OLD HOOK RD
Practice Address - Street 2:SUITE #105
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3200
Practice Address - Country:US
Practice Address - Phone:201-599-8440
Practice Address - Fax:201-599-8427
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA58332207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G71789Medicare UPIN
088696Medicare ID - Type Unspecified