Healthcare Provider Details

I. General information

NPI: 1144267683
Provider Name (Legal Business Name): SANJEEV KAUL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SUMMIT AVE SUITE 105
HACKENSACK NJ
07601-8503
US

IV. Provider business mailing address

PO BOX 8
TENAFLY NJ
07670-0008
US

V. Phone/Fax

Practice location:
  • Phone: 201-996-2900
  • Fax:
Mailing address:
  • Phone: 201-373-6223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMA67369
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number325207-01
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: