Individual
KAPPUKALAR A ZIYAAUDHIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
186 W MARKET ST, STE 211A, NEWARK, NJ 07103-2783
(973) 623-9011
(973) 624-1208
Mailing address
186 W MARKET ST, STE 211A, NEWARK, NJ 07103-2783
(973) 623-9011
(973) 624-1208
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA03218600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3035506
—
NJ
Enumeration date
08/17/2005
Last updated
07/08/2007
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