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Organization
RIDGE ROAD PHYSICIANS LLC
Active
Organization
RIDGE ROAD PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRAN M MEDASANI M.D (MEMBER)
(908) 670-4136
Entity
Organization
Contact information
Practice address
222 SOUTH ST, FREEHOLD, NJ 07728-2619
(732) 387-7795
Mailing address
399 GALLYA GRV, MORGANVILLE, NJ 07751-4444
(908) 670-4136
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA08924900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417251703
NPI
NJ
Enumeration date
08/16/2012
Last updated
05/07/2015
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