Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | FS1402546 | NJ |
NPI | 1194919340 |
---|---|
Provider Name | Mr. Kumar Gautam Sinha |
First Address | Wayne, NJ 07470-3534 |
Second Address | Wayne, NJ 07470-3534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2007 |
Last Update Date | 02/06/2010 |