Provider Demographics
NPI:1972535060
Name:GIYANANI, SUNITA M
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:M
Last Name:GIYANANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 MCCLAIN DR
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08361-6138
Mailing Address - Country:US
Mailing Address - Phone:856-691-5262
Mailing Address - Fax:
Practice Address - Street 1:70 COHANSEY ST
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1918
Practice Address - Country:US
Practice Address - Phone:856-451-4700
Practice Address - Fax:856-451-0029
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA02682200207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC53401Medicare UPIN
NJ124834Medicare ID - Type Unspecified