Individual
DR. SUJATHA SUKHAVASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 BOULEVARD, PASSAIC, NJ 07055-2840
(973) 365-4300
(845) 357-5777
Mailing address
100 ROUTE 59, SUITE 105, SUFFERN, NY 10901-4927
(845) 357-5775
(845) 357-5777
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
238812
NY
207L00000X
Anesthesiology Physician
Primary
25MA08046800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149594
—
NJ
05
—
03357320
—
NY
Enumeration date
12/07/2007
Last updated
06/18/2013
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