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General NPI Number Information
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NPI Number | 1720287295
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Entity Type | Individual
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Provider Name | SUDHANSHU JAIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 506 LENOX AVE SUITE 1203
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City | NEW YORK
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State | NY
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Zip | 10037-1802
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Country | US
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Telephone | 212-939-1466
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Fax | 212-939-1745
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Provider Business Mailing Address
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Address Line | 2 COZY DR
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City | MANALAPAN
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State | NJ
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Zip | 07726-8836
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Country | US
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Telephone | 216-233-2728
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 269730
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License Number State | NY
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