Healthcare Provider Details

I. General information

NPI: 1851766588
Provider Name (Legal Business Name): SUNDUS ABBASI D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 05/20/2023
Certification Date: 05/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 EASTON AVE FL 3
NEW BRUNSWICK NJ
08901-1723
US

IV. Provider business mailing address

629 CRANBURY RD FL 2
EAST BRUNSWICK NJ
08816-4096
US

V. Phone/Fax

Practice location:
  • Phone: 732-846-3300
  • Fax: 732-846-3323
Mailing address:
  • Phone: 732-390-7750
  • Fax: 732-390-7725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number25MB10773500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: