Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MA028825 | NJ |
NPI | 1568513539 |
---|---|
Provider Name | Usha Sundaram |
First Address | Union, NJ 07083-5714 |
Second Address | Union, NJ 07083-5714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |