Individual
REKHA MIRYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1018 BROAD STREET, SUITE 8, BLOOMFIELD, NJ 07003-2884
(973) 338-4900
Mailing address
1018 BROAD STREET, SUITE 8, BLOOMFIELD, NJ 07003-2884
(973) 338-4900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA08463200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0235067
—
NJ
Enumeration date
01/14/2008
Last updated
12/22/2010
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