Healthcare Provider Details

I. General information

NPI: 1841245230
Provider Name (Legal Business Name): SUMITA BERY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 01/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DRIVE
FLEMINGTON NJ
08822
US

IV. Provider business mailing address

PO BOX 29 HUNTERDON ANESTHESIA ASSOCIATES
OLDWICK NJ
08858-0029
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6100
  • Fax:
Mailing address:
  • Phone: 908-534-0792
  • Fax: 908-236-0637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA07080800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA70808
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: