Healthcare Provider Details

I. General information

NPI: 1972535060
Provider Name (Legal Business Name): SUNITA M GIYANANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 COHANSEY ST
BRIDGETON NJ
08302-1918
US

IV. Provider business mailing address

940 MCCLAIN DR
VINELAND NJ
08361-6138
US

V. Phone/Fax

Practice location:
  • Phone: 856-451-4700
  • Fax: 856-451-0029
Mailing address:
  • Phone: 856-691-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMA02682200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: