Provider Demographics
NPI:1053570374
Name:NAIR, ANIL KARUNAKARAN (MD)
Entity type:Individual
Prefix:DR
First Name:ANIL
Middle Name:KARUNAKARAN
Last Name:NAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 COMMERCE AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5025
Mailing Address - Country:US
Mailing Address - Phone:908-688-8800
Mailing Address - Fax:908-688-2377
Practice Address - Street 1:1057 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5025
Practice Address - Country:US
Practice Address - Phone:908-688-8800
Practice Address - Fax:908-688-2377
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08956700207T00000X, 207T00000X
IL036.128290207T00000X
NY262452207T00000X
AZ49852207T00000X
NYAA111564862292390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0284149Medicaid
PA102554486Medicaid
PA803545Medicare PIN
NJ235536Medicare PIN