Individual
DIVYA MOUNISHA REDDY THIMMAREDDYGARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 877-5000
Mailing address
57 E CENTRE ST APT 2114, NUTLEY, NJ 07110-5413
(470) 485-3437
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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