Provider Demographics
NPI:1992855258
Name:KARUNANITHI, SUBHATHRA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUBHATHRA
Middle Name:
Last Name:KARUNANITHI
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 1:41-97 RYS TER
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-5813
Mailing Address - Country:US
Mailing Address - Phone:201-254-9140
Mailing Address - Fax:
Practice Address - Street 1:206 BERGEN AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3324
Practice Address - Country:US
Practice Address - Phone:201-998-7474
Practice Address - Fax:201-998-6550
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08166100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine