Individual
NEELIMA VUDARLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1450 PARKSIDE AVE STE 4, EWING, NJ 08638-2948
(609) 789-0777
(609) 789-0776
Mailing address
1450 PARKSIDE AVE STE 4, EWING, NJ 08638-2948
(609) 789-0777
(609) 789-0776
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA08594900
NJ
208M00000X
Hospitalist Physician
25MA08594900
NJ
208M00000X
Hospitalist Physician
C1-0008538
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102290468 0001
—
PA
01
—
30060273
KEYSTONE MERCY
PA
01
—
3546646000
KEYSTONE HEALTH PLAN EAST
PA
01
—
P00765931
RR MEDICARE
PA
Enumeration date
11/08/2007
Last updated
04/15/2024
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