Provider Demographics
NPI:1043593999
Name:BATH SOHAL, PARMINDER
Entity type:Individual
Prefix:
First Name:PARMINDER
Middle Name:
Last Name:BATH SOHAL
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 1:900 MEDICAL CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2358
Mailing Address - Country:US
Mailing Address - Phone:856-557-7900
Mailing Address - Fax:856-589-3989
Practice Address - Street 1:900 MEDICAL CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2358
Practice Address - Country:US
Practice Address - Phone:856-557-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010434363LF0000X
NJ26NJ00269300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
07/27/1973OtherBIRTH DATE