Individual
MS. RUMANTHA MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 LOWER MAIN STREET, SOUTH AMBOY, NJ 08879
(732) 727-2555
(732) 727-0255
Mailing address
65 HAWTHORNE PL, G-2, MONTCLAIR, NJ 07042-2621
(973) 509-5782
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
32707
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1074504
—
NJ
Enumeration date
02/23/2007
Last updated
07/08/2007
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