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Individual
SOWMYA KANIKKANNAN
Active
Individual
SOWMYA KANIKKANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA09242700
NJ
207R00000X
Internal Medicine Physician
MD430524
PA
208M00000X
Hospitalist Physician
Primary
25MA09242700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0342467
—
NJ
05
—
1018195960001
—
PA
05
—
1018195960002
—
PA
05
—
1018195960003
—
PA
01
—
2094417
HIGHMARK BLUE SHIELD
PA
01
—
2854908000
INDEPENDENCE BCBS
PA
01
—
P01224369
RAILROAD MEDICARE
NJ
Enumeration date
01/23/2007
Last updated
02/19/2015
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