Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 212623 | NY |
N | 208G00000X | Cardiothoracic Vascular Surgeon | ME103129 | FL |
NPI | 1063568665 |
---|---|
Provider Name | Sunil Prakash Malhotra |
First Address | Newark, NJ 07112-2027 |
Second Address | Newark, NJ 07112-2027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 13/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000501500 | (05) | FL |