Healthcare Provider Details

I. General information

NPI: 1972608362
Provider Name (Legal Business Name): SUNIL SABHARWAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VA MEDICAL CENTER 1400 VFW PARKWAY, SCI-128
WEST ROXBURY MA
02492
US

IV. Provider business mailing address

1 SOUTHFIELD CT
NEEDHAM MA
02492-2782
US

V. Phone/Fax

Practice location:
  • Phone: 857-203-6574
  • Fax:
Mailing address:
  • Phone: 857-203-6574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number227848
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number227848
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: