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Individual

DR. KANCHANA BALASUBRAMANIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
6 WALTER CT, RUTHERFORD, NJ 07070-2558
(201) 893-2939
(201) 460-0770
Mailing address
6 WALTER CT, RUTHERFORD, NJ 07070-2558
(201) 893-2939
(201) 460-0770

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07605600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0016497
NJ
01
11266126
CAQH
NJ
Enumeration date
06/11/2006
Last updated
02/02/2012
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