Individual
PRATHIBHA POTHARLANKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
218 SUNSET RD, WILLINGBORO, NJ 08046-1110
(609) 835-2900
(856) 566-2797
Mailing address
30 BELMONT CIR, COLUMBUS, NJ 08022-9714
(609) 789-0800
(609) 298-0491
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA07690100
NJ
208M00000X
Hospitalist Physician
Primary
25MA07690100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0033120
—
NJ
05
—
0078875
—
NJ
01
—
7221574
AETNA PPO
NJ
01
—
P00603546-MERCER
RAILROAD MEDICARE
NJ
Enumeration date
06/25/2006
Last updated
09/06/2016
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