Individual
LAISA LUKOSE VADAKARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1401 WHITEHORSE MERCERVILLE RD STE 220, HAMILTON, NJ 08619-3835
(609) 249-6664
Mailing address
1401 WHITEHORSE MERCERVILLE RD STE 220, HAMILTON, NJ 08619-3835
(609) 249-6664
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA62648
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7005105
—
NJ
Enumeration date
08/09/2006
Last updated
12/13/2023
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