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General NPI Number Information
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NPI Number | 1639223050
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Entity Type | Individual
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Provider Name | SOWMYA KANIKKANNAN MD
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 02/19/2015
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Provider Practice Location Address
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Address Line | 18 E LAUREL RD KENNEDY HOSPITAL
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City | STRATFORD
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State | NJ
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Zip | 08084-1327
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Country | US
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Telephone | 856-566-6845
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Fax | 856-566-6906
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Provider Business Mailing Address
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Address Line | 18 E LAUREL RD KENNEDY HOSPITAL
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City | STRATFORD
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State | NJ
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Zip | 08084-1327
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Country | US
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Telephone | 856-566-6845
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Fax | 856-566-6906
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD430524
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 25MA09242700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA09242700
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License Number State | NJ
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