Individual
GAUTAMI KONDAMODI RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
242 W PARKWAY, POMPTON PLAINS, NJ 07444-1029
(908) 522-2829
(908) 522-6147
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25MA08365500
NJ
2084N0600X
Clinical Neurophysiology Physician
044606
CT
2084N0600X
Clinical Neurophysiology Physician
25MA08365500
NJ
Other
Enumeration date
10/17/2006
Last updated
02/16/2022
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