Individual
JAYA REDDY KOTHAPALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
218 C. SUNSET ROAD, WILLINGBORO, NJ 08046
(609) 877-0400
(609) 877-3542
Mailing address
218 C. SUNSET ROAD, WILLINGBORO, NJ 08046
(609) 877-0400
(609) 877-3542
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
25MA08944000
NJ
390200000X
Student in an Organized Health Care Education/Training Program
2006012190
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA08944000
MEDICAL LICENSE
NJ
Enumeration date
08/30/2006
Last updated
06/11/2014
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