Provider Demographics
NPI:1962957597
Name:SUNIL ASNANI, M.D. L.L.C.
Entity type:Organization
Organization Name:SUNIL ASNANI, M.D. L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ASNANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-686-9144
Mailing Address - Street 1:PO BOX 696
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-0696
Mailing Address - Country:US
Mailing Address - Phone:732-686-9144
Mailing Address - Fax:
Practice Address - Street 1:3350 ROUTE 138
Practice Address - Street 2:SUITE 118
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-9693
Practice Address - Country:US
Practice Address - Phone:732-686-9144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08126200261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0113646Medicaid
NJH96000Medicare UPIN