Healthcare Provider Details

I. General information

NPI: 1780091736
Provider Name (Legal Business Name): SUKHWINDER K. HUNDLE M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 N BEERS ST STE 1A
HOLMDEL NJ
07733-1500
US

IV. Provider business mailing address

721 N BEERS ST STE 1A
HOLMDEL NJ
07733-1500
US

V. Phone/Fax

Practice location:
  • Phone: 732-739-3555
  • Fax: 732-845-0226
Mailing address:
  • Phone: 732-739-3555
  • Fax: 732-845-0226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SUKHWINDER K. HUNDLE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 732-739-3555