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General NPI Number Information
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NPI Number | 1184971558
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Entity Type | Organization
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Legal Business Name | SKR MEDICAL ADVISORS
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Dates
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Enumeration Date | 08/05/2012
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 560 NEW YORK AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-1532
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Country | US
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Telephone | 201-345-3839
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Fax | 201-345-4536
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Provider Business Mailing Address
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Address Line | 560 NEW YORK AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-1532
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Country | US
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Telephone | 201-345-3839
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Fax | 201-345-4536
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. SATISH KUMAR REDDY
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Credential | M.D.
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Telephone | 312-523-9505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 25MA09104500
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License Number State | NJ
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