Individual
KALAVATHY BALAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
703 MAIN ST, PATERSON, NJ 07503-2621
(973) 754-2645
Mailing address
91 STILES RD, ATT:SHARON SILVA, SALEM, NH 03079-2846
(603) 890-4404
(603) 893-8886
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA04427600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0963909
—
NJ
Enumeration date
09/29/2005
Last updated
12/10/2009
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