Provider Demographics
NPI:1174803159
Name:GOPAL K. SINHA MD PA
Entity type:Organization
Organization Name:GOPAL K. SINHA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GOPAL
Authorized Official - Middle Name:KRISHNA
Authorized Official - Last Name:SINHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-650-0009
Mailing Address - Street 1:2 ETHEL RD
Mailing Address - Street 2:SUITE 206 C
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2839
Mailing Address - Country:US
Mailing Address - Phone:732-650-0009
Mailing Address - Fax:732-650-1976
Practice Address - Street 1:2 ETHEL RD
Practice Address - Street 2:SUITE 206 C
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2839
Practice Address - Country:US
Practice Address - Phone:732-650-0009
Practice Address - Fax:732-650-1976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02747000261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56172Medicare UPIN