Individual
DR. GNANA SUNDERAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 CENTRAL AVE, SUITE 205, EAST ORANGE, NJ 07018-2835
(973) 266-9111
(973) 266-1227
Mailing address
310 CENTRAL AVE, SUITE 205, EAST ORANGE, NJ 07018-2835
(973) 266-9111
(973) 266-1227
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA0429800
NJ
207RP1001X
Pulmonary Disease Physician
25MA0429800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1264508
—
NJ
Enumeration date
07/27/2006
Last updated
06/10/2024
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