Healthcare Provider Details

I. General information

NPI: 1568600385
Provider Name (Legal Business Name): SUKETU NANAVATI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2009
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 VILLAGE DR
CAPE MAY COURT HOUSE NJ
08210-1939
US

IV. Provider business mailing address

2 VILLAGE DR
CAPE MAY COURT HOUSE NJ
08210-1939
US

V. Phone/Fax

Practice location:
  • Phone: 609-465-7517
  • Fax: 609-465-2448
Mailing address:
  • Phone: 609-465-7517
  • Fax: 609-465-2448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code207RA0002X
TaxonomyAdult Congenital Heart Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SUKETU H NANAVATI
Title or Position: OWNER
Credential:
Phone: 609-465-7515