Organization
KENILWORTH PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHAVANI JEEREDDY M.D. (SOLE MEMBER)
(908) 276-9595
Entity
Organization
Contact information
Practice address
66 S 21ST ST, KENILWORTH, NJ 07033-1626
(908) 276-9595
(908) 276-6807
Mailing address
66 S 21ST ST, KENILWORTH, NJ 07033-1626
(908) 276-9595
(908) 276-6807
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
NJ
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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