Individual
DR. NAGA MALLESWARI KOMATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
767 NORTHFIELD AVENUE, WEST ORANGE, NJ 07052-1194
(973) 419-0417
(862) 766-5904
Mailing address
767 NORTHFIELD AVENUE, WEST ORANGE, NJ 07052-1194
(973) 992-9022
(973) 992-9024
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08336000
NJ
207RN0300X
Nephrology Physician
Primary
25MA08336000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0169790
—
NJ
01
—
P00778377
RR MEDICARE
NJ
Enumeration date
05/18/2007
Last updated
08/23/2013
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