Healthcare Provider Details

I. General information

NPI: 1366350381
Provider Name (Legal Business Name): STAR BERGEN MED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MURRAY HILL TER APT C5
BERGENFIELD NJ
07621-3033
US

IV. Provider business mailing address

1 MURRAY HILL TER APT C5
BERGENFIELD NJ
07621-3033
US

V. Phone/Fax

Practice location:
  • Phone: 347-854-3011
  • Fax:
Mailing address:
  • Phone: 551-250-3084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: AMINA SUNDAS
Title or Position: CEO
Credential:
Phone: 551-250-3084