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Organization
SUDHA KOLLI MD PA
Active
Organization
SUDHA KOLLI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHA KOLLI MD (PHYSICIAN)
(732) 249-2044
Entity
Organization
Contact information
Practice address
330 LIVINGSTON AVE, NEW BRUNSWICK, NJ 08901
(732) 249-2044
(732) 249-6225
Mailing address
PO BOX 349, BASKING RIDGE, NJ 07920
(732) 249-2044
(908) 253-0053
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000598201
AMERICHOICE
—
01
—
1165329
HORIZON NJ HEALTH
—
01
—
2075976001
KEYSTONE
—
01
—
28658
UNIVERSITY HEALTH PLAN
—
01
—
2K0392
HEALTHNET
—
05
—
8181705
—
NJ
01
—
P2212167
OXFORD
—
Enumeration date
03/14/2007
Last updated
08/22/2020
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