Basic Information
| Provider Information | |||||||||
| NPI: | 1508312315 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABEL BOENERJOUS | ||||||||
| FirstName: | SUHAS | ||||||||
| MiddleName: | MASILAMANI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 WILLOWBROOK LN | ||||||||
| Address2: | SWEDESBORO | ||||||||
| City: | SWEDESBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080851682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3479186822 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1650 GRAND CONCURSE, | ||||||||
| Address2: | BRONX-LEBANON HOSPITAL CENTER | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185901800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2016 | ||||||||
| LastUpdateDate: | 08/31/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.