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Individual

MARY G CHOLANKERIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
240 WILLIAMSON ST, STE 205, ELIZABETH, NJ 07207
(908) 289-2070
(908) 289-4890
Mailing address
240 WILLIAMSON ST, STE 205, ELIZABETH, NJ 07207
(908) 289-2070
(908) 289-4890

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA0389900
NJ
207RH0003X
Hematology & Oncology Physician
Primary
25MA0389900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2105306
NJ
Enumeration date
11/27/2006
Last updated
05/07/2012
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