Organization
HOLMDEL PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOWMINI KOMMIREDDI M.D. (PRESIDENT)
(732) 290-1063
Entity
Organization
Contact information
Practice address
719 N BEERS ST, SUITE 1E, HOLMDEL, NJ 07733-1522
(732) 290-1063
(732) 739-9537
Mailing address
719 N BEERS ST, SUITE 1E, HOLMDEL, NJ 07733-1522
(732) 290-1063
(732) 739-9537
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
25MA073809
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154462604
NPI
NJ
01
—
1518064260
NPI
NJ
05
—
9078502
—
NJ
Enumeration date
06/10/2009
Last updated
06/10/2009
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