Individual
RENJY VATTASSERIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
217 N MAIN ST, SUITE 102, CAPE MAY COURT HOUSE, NJ 08210-2165
(609) 536-8010
(609) 536-8053
Mailing address
1 FEDERAL ST STE 200, CAMDEN, NJ 08103-1088
(848) 288-6935
(732) 790-0107
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
239444
NY
207RG0100X
Gastroenterology Physician
Primary
25MA08709900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0232475
—
NJ
01
—
P01227607
RAILROAD MEDICARE
NJ
Enumeration date
07/10/2006
Last updated
04/01/2025
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