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Individual

ANISH KUMAR KANUKUNTLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
OCEAN UNIVERSITY MEDICAL CENTER, 425 JACK MARTIN BLVD., BRICK, NJ 08724
(732) 840-2200
Mailing address
OCEAN UNIVERSITY MEDICAL CENTER, 425 JACK MARTIN BLVD., BRICK, NJ 08724
(732) 840-2200

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA12694100
NJ
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
07/13/2022
Last updated
02/18/2026
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