Provider Demographics
NPI:1285625244
Name:VERMA, SUNJAY (MD)
Entity type:Individual
Prefix:
First Name:SUNJAY
Middle Name:
Last Name:VERMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MURRAY ST
Mailing Address - Street 2:PO BOX 985
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4311
Mailing Address - Country:US
Mailing Address - Phone:518-793-1000
Mailing Address - Fax:518-793-1976
Practice Address - Street 1:11 MURRAY ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4311
Practice Address - Country:US
Practice Address - Phone:518-793-1000
Practice Address - Fax:518-793-1976
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2209752085R0202X, 2085N0700X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C34824Medicare UPIN
CC7713Medicare ID - Type Unspecified