Individual
DR. SUMAN JAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 PROSPECT ST, LAKEWOOD, NJ 08701-5020
(732) 363-1424
(732) 370-0714
Mailing address
1366 VINCENZO DR, TOMS RIVER, NJ 08753-2768
(732) 286-5295
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA58443
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5323 908
—
NJ
Enumeration date
09/22/2006
Last updated
07/08/2007
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