Individual
LUCYAMMA THALODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
240 WILLIAMSON ST, SUITE 400, ELIZABETH, NJ 07207
(908) 352-0560
(908) 352-4066
Mailing address
240 WILLIAMSON ST, SUITE 400, ELIZABETH, NJ 07207
(908) 352-0560
(908) 352-4066
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA03193500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1663909
—
NJ
Enumeration date
08/24/2006
Last updated
03/26/2010
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