Individual
MRS. SUDHA R KOLLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
262 LIVINGSTON AVE, NEW BRUNSWICK, NJ 08901-3058
(732) 249-2044
(732) 790-2626
Mailing address
262 LIVINGSTON AVE, NEW BRUNSWICK, NJ 08901-3058
(732) 249-2044
(732) 790-2626
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA06951300
NJ
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MA69513
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8181705
—
NJ
Enumeration date
09/25/2006
Last updated
03/13/2017
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