Provider Demographics
NPI:1194978114
Name:MANPREET SAHOTA MD PC
Entity type:Organization
Organization Name:MANPREET SAHOTA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANPREET
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SAHOTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-447-8436
Mailing Address - Street 1:PO BOX 437
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-0437
Mailing Address - Country:US
Mailing Address - Phone:908-447-8436
Mailing Address - Fax:862-248-0189
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:908-447-8436
Practice Address - Fax:862-248-0189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA052342261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical