Kolli, Sudha R

Kolli, Sudha R is an individual health care provider with primary practice located at 262 Livingston Ave , New Brunswick NJ 08901-3058. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is her primary health care specialty. Kolli, Sudha R can be contacted via phone (732) 249-2044.

Contact Information

Primary practice address
262 Livingston Ave New Brunswick NJ 08901-3058
Phone: (732) 249-2044
Fax: (732) 790-2626
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X MA69513 New Jersey
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25MA06951300 New Jersey

Profile Details

NPI number 1174623508
LBN Legal business name Kolli, Sudha R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Mar 13th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174623508 NPPES
New Jersey MEDICAID 8181705

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