Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 25MA07398700 | NJ |
NPI | 1053397224 |
---|---|
Provider Name | Hemalatha Vasireddy |
First Address | Belleville, NJ 07109-3550 |
Second Address | Belleville, NJ 07109-3550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 28/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8975001 | (05) | NJ |
H70710 | (02) |