Healthcare Provider Details

I. General information

NPI: 1033245311
Provider Name (Legal Business Name): SWETHA D VODDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 WHITEHORSE MERCERVILLE RD SUITE 219
HAMILTON NJ
08619-3835
US

IV. Provider business mailing address

1401 WHITEHORSE MERCERVILLE RD STE 219
HAMILTON NJ
08619-3835
US

V. Phone/Fax

Practice location:
  • Phone: 609-584-5150
  • Fax: 609-584-5144
Mailing address:
  • Phone: 609-584-5150
  • Fax: 609-584-5144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number245070
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number25MA09566200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: