Provider Demographics
NPI:1245437367
Name:ALBERT, SUNIL DAVID (MD)
Entity type:Individual
Prefix:
First Name:SUNIL
Middle Name:DAVID
Last Name:ALBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:500 W MAIN ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-3027
Mailing Address - Country:US
Mailing Address - Phone:631-422-6166
Mailing Address - Fax:
Practice Address - Street 1:500 W MAIN ST
Practice Address - Street 2:SUITE 116
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-3027
Practice Address - Country:US
Practice Address - Phone:631-422-6166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2447972081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY70E54LL821Medicare PIN