Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | #25MA09351400 | NJ |
N | 2081S0010X | Sports Medicine | #25MA09351400 | NJ |
N | 213ES0000X | Sports Medicine | #25MA09351400 | NJ |
NPI | 1497912489 |
---|---|
Provider Name | Dr. Kiran Vadada |
First Address | Honolulu, HI 96813-3097 |
Second Address | Honolulu, HI 96813-3097 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2008 |
Last Update Date | 13/08/2016 |