Provider Demographics
NPI:1457926396
Name:SUTARIA, SAGAR
Entity Type:Individual
Prefix:
First Name:SAGAR
Middle Name:
Last Name:SUTARIA
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 1:350 PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3119
Mailing Address - Country:US
Mailing Address - Phone:609-799-0233
Mailing Address - Fax:609-275-7331
Practice Address - Street 1:350 PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-3119
Practice Address - Country:US
Practice Address - Phone:609-799-0233
Practice Address - Fax:609-275-7331
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04166500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist