Individual
HARISH KAKKILAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 BERLIN CROSS KEYS RD, SICKLERVILLE, NJ 08081
(856) 673-4500
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA08543800
NJ
208600000X
Surgery Physician
C1-0011498
DE
208600000X
Surgery Physician
D0067469
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0198617
—
NJ
Enumeration date
05/23/2008
Last updated
07/09/2025
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