Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 25MA09473800 | NJ |
NPI | 1154556835 |
---|---|
Provider Name | Dr. Sujoy Menon |
First Address | Short Hills, NJ 07078-1617 |
Second Address | Newark, NJ 07112-2027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2009 |
Last Update Date | 08/04/2021 |