Provider Demographics
NPI:1932375581
Name:SARKAR, SHUBHO RANJAN (MD)
Entity Type:Individual
Prefix:
First Name:SHUBHO
Middle Name:RANJAN
Last Name:SARKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 MADISON AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7360
Mailing Address - Country:US
Mailing Address - Phone:973-631-6223
Mailing Address - Fax:973-631-6225
Practice Address - Street 1:131 MADISON AVE STE 3
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7360
Practice Address - Country:US
Practice Address - Phone:973-631-6223
Practice Address - Fax:973-631-6225
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08385900207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0164674Medicaid