Provider Demographics
NPI:1881989671
Name:SUDHAKAR J. KHAROD, M.D., P.A.
Entity type:Organization
Organization Name:SUDHAKAR J. KHAROD, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUDHAKAR
Authorized Official - Middle Name:J
Authorized Official - Last Name:KHAROD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-774-5600
Mailing Address - Street 1:507 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-6009
Mailing Address - Country:US
Mailing Address - Phone:732-774-5600
Mailing Address - Fax:
Practice Address - Street 1:507 4TH AVE
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-6009
Practice Address - Country:US
Practice Address - Phone:732-774-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03000600261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care