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Organization
TARA P. KANETKAR, MD, PA
Active
Organization
TARA P. KANETKAR, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA P KANETKAR MD (OWNER)
(732) 985-2151
Entity
Organization
Contact information
Practice address
2149 WOODBRIDGE AVE, EDISON, NJ 08817-4474
(732) 985-2151
(732) 985-0650
Mailing address
2149 WOODBRIDGE AVE, EDISON, NJ 08817-4474
(732) 985-2151
(732) 985-0650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA023527
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2091704
—
NJ
Enumeration date
02/01/2007
Last updated
09/20/2007
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