Individual
GAYATHRI SUBRAMANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., D.M.D
Contact information
Practice address
110 BERGEN ST, NEWARK, NJ 07103-2495
(732) 824-7241
Mailing address
2 HART DR, WEST ORANGE, NJ 07052-1147
(973) 731-1154
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DR02354
NJ
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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