Provider Demographics
NPI:1104223932
Name:SUNGA, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SUNGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 KNICKERBOCKER RD APT 1F
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-1348
Mailing Address - Country:US
Mailing Address - Phone:201-208-7654
Mailing Address - Fax:
Practice Address - Street 1:420 KNICKERBOCKER RD APT 1F
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-1348
Practice Address - Country:US
Practice Address - Phone:201-208-7654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist