Organization
ACADEMIC ICU DOC, PA
Active
Organization
ACADEMIC ICU DOC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRI SUJANTHY RAJARAM MD (PRESIDENT)
(908) 464-3636
Entity
Organization
Contact information
Practice address
5 RUSHTON CT, WEST WINDSOR, NJ 08550-3320
(908) 464-3636
(908) 464-6711
Mailing address
5 RUSHTON CT, WEST WINDSOR, NJ 08550-3320
(908) 464-3636
(908) 464-6711
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0450016696
STATE ID
NJ
Enumeration date
09/17/2015
Last updated
02/17/2016
Update your record
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