Individual
KOMALA DEVI MALLAMPATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
514 JOYCE ST, ORANGE, NJ 07050-1411
(973) 672-2214
(973) 672-1320
Mailing address
514 JOYCE ST, ORANGE, NJ 07050-1411
(973) 672-2214
(973) 672-1320
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MA41876
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6413901
—
NJ
Enumeration date
01/17/2006
Last updated
07/08/2007
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