Provider Demographics
NPI:1841247186
Name:SUNDARAM, UMA (MD)
Entity type:Individual
Prefix:DR
First Name:UMA
Middle Name:
Last Name:SUNDARAM
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 1:2101 FRIAR CT
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9744
Mailing Address - Country:US
Mailing Address - Phone:732-974-2834
Mailing Address - Fax:732-974-2843
Practice Address - Street 1:1541 ROUTE 88 W
Practice Address - Street 2:SUITE B
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-2373
Practice Address - Country:US
Practice Address - Phone:732-458-5000
Practice Address - Fax:732-458-6265
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA049947002080N0001X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics