Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | MB 66137 | NJ |
NPI | 1225170954 |
---|---|
Provider Name | Dr. Anudeep Momi |
First Address | Voorhees, NJ 08043-9542 |
Second Address | Voorhees, NJ 08043-9542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 02/04/2008 |