Healthcare Provider Details

I. General information

NPI: 1447325311
Provider Name (Legal Business Name): RAMANASRI V KUDIPUDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2006
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CN 5050, 901 WEST MAIN STREET SUITE 260
FREEHOLD NJ
07728
US

IV. Provider business mailing address

31 YELLOW BROOK RD
HOLMDEL NJ
07733-1967
US

V. Phone/Fax

Practice location:
  • Phone: 732-685-9243
  • Fax: 732-631-9924
Mailing address:
  • Phone: 732-685-9243
  • Fax: 732-631-9924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA07472000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: