Provider Demographics
NPI:1871599423
Name:SODHI, SURINDER K (MD)
Entity type:Individual
Prefix:
First Name:SURINDER
Middle Name:K
Last Name:SODHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 US HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-4924
Mailing Address - Country:US
Mailing Address - Phone:908-561-4300
Mailing Address - Fax:908-561-4340
Practice Address - Street 1:719 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-4924
Practice Address - Country:US
Practice Address - Phone:908-561-4300
Practice Address - Fax:908-561-4340
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05498100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4523903Medicaid
NJ4523903Medicaid
NJ863335Medicare ID - Type Unspecified