Provider Demographics
NPI:1982851077
Name:GURUNATHAN, SANJAY
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:
Last Name:GURUNATHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 COBBLESTONE LN
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8917
Mailing Address - Country:US
Mailing Address - Phone:610-614-0929
Mailing Address - Fax:
Practice Address - Street 1:263 COBBLESTONE LN
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8917
Practice Address - Country:US
Practice Address - Phone:610-614-0929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD052089L207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease