Individual
KAMALAKAR VANAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 PARK AVE, PLAINFIELD, NJ 07061
(908) 668-2200
(908) 668-6894
Mailing address
307 S EVERGREEN AVE, WOODBURY, NJ 08096-2739
(856) 686-4300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MA67133
NJ
207R00000X
Internal Medicine Physician
Primary
25MA06713300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0090964
—
NJ
01
—
P00652870
RAILROAD MEDICARE
NJ
Enumeration date
06/15/2006
Last updated
08/26/2021
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