Individual
KEERTI THALAYUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
646 KINGS HWY, WEST DEPTFORD, NJ 08096
(856) 879-2887
(856) 879-2855
Mailing address
117 OAKRIDGE DR, MOUNT ROYAL, NJ 08061-1097
(201) 233-0896
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA08950300
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/19/2010
Last updated
08/28/2018
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