Individual
RAO S MIKKILINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
377 JERSEY AVE, STE 470, JERSEY CITY, NJ 07302-4393
(201) 918-2239
(201) 918-2243
Mailing address
391 MARTINSVILLE RD, BASKING RIDGE, NJ 07920-2713
(908) 625-6938
(973) 597-1076
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MA51744
NJ
207RP1001X
Pulmonary Disease Physician
MA51744
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1582208
—
NJ
Enumeration date
04/25/2006
Last updated
04/22/2020
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