Healthcare Provider Details

I. General information

NPI: 1053872556
Provider Name (Legal Business Name): DARREN LYNDON SULTAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PROSPECT AVE STE 903
HACKENSACK NJ
07601-1999
US

IV. Provider business mailing address

200 SCHULZ DR STE 2
RED BANK NJ
07701-6745
US

V. Phone/Fax

Practice location:
  • Phone: 732-426-3420
  • Fax:
Mailing address:
  • Phone: 732-333-8720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number25MA13191800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: