Individual
KAVITA R PESHORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
44 E JIMMIE LEEDS RD, STE 101, GALLOWAY, NJ 08205-9599
(609) 677-9729
Mailing address
72 W JIMMIE LEEDS RD, STE 1100, GALLOWAY, NJ 08205-9406
(609) 677-9729
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA08988800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0273449
—
NJ
01
—
P00979663
RR MEDICARE
NJ
01
—
P00979668
RR MEDICARE
NJ
01
—
P00983170
RR MEDICARE
NJ
Enumeration date
02/02/2009
Last updated
04/05/2012
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