Organization
LIBERTY PULMONARY CRITICAL CARE
Active
Organization
LIBERTY PULMONARY CRITICAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAO MIKKILINENI M.D. (MANAGING PARTNER)
(201) 795-9155
Entity
Organization
Contact information
Practice address
355 GRAND ST, JERSEY CITY, NJ 07302-4321
(201) 795-9155
Mailing address
PO BOX 1557, LIVINGSTON, NJ 07039-7157
(973) 202-6120
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
11/30/2007
Last updated
11/30/2007
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