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General NPI Number Information
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NPI Number | 1194116525
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Entity Type | Organization
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Legal Business Name | KURUDI LLC
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Dates
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Enumeration Date | 02/06/2015
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Last Update Date | 02/06/2015
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Provider Practice Location Address
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Address Line | 175 CROSS KEYS RD SUITE 103
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City | BERLIN
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State | NJ
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Zip | 08009-9263
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Country | US
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Telephone | 856-753-3368
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Fax | 856-753-3367
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Provider Business Mailing Address
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Address Line | 175 CROSS KEYS RD SUITE 103
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City | BERLIN
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State | NJ
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Zip | 08009-9263
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Country | US
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Telephone | 856-753-3368
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Fax | 856-753-3367
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | CINDY CAFARO
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Credential |
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Telephone | 631-486-7710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22D102318300
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License Number State | NJ
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