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Organization

KODALI NEPHROLOGY AND HYPERTENTION CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PADMAJA KODALI M.D (DOCTOR)
(973) 763-1100
Entity
Organization

Contact information

Practice address
2040 MILLBURN AVE, SUITE 403, MAPLEWOOD, NJ 07040-3726
(973) 763-1100
(973) 763-1122
Mailing address
2040 MILLBURN AVE, SUITE 403, MAPLEWOOD, NJ 07040-3726
(973) 763-1100
(973) 763-1122

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
25MA06878300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8348707
NJ
Enumeration date
10/11/2007
Last updated
01/02/2008
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