Healthcare Provider Details

I. General information

NPI: 1831199496
Provider Name (Legal Business Name): SUSHMA SAHNI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 04/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

498 MAIN ST
SPOTSWOOD NJ
08884-1702
US

IV. Provider business mailing address

498 MAIN ST
SPOTSWOOD NJ
08884-1702
US

V. Phone/Fax

Practice location:
  • Phone: 732-251-6900
  • Fax: 732-251-5935
Mailing address:
  • Phone: 732-251-6900
  • Fax: 732-251-5935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA03871000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: