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General NPI Number Information
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NPI Number | 1760528681
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Entity Type | Organization
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Legal Business Name | KINNELON MEDICAL & PEDIATRIC ASSOCIATES, PA
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 170 KINNELON RD STE 28
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City | KINNELON
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State | NJ
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Zip | 07405-2347
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Country | US
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Telephone | 973-838-1717
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Fax | 973-838-1775
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Provider Business Mailing Address
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Address Line | 170 KINNELON RD STE 28
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City | KINNELON
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State | NJ
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Zip | 07405-2347
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Country | US
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Telephone | 973-838-1717
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Fax | 973-838-1775
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ABHAY K SUDA
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Credential | M.D.
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Telephone | 973-838-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MA34985
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MA43353
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA08006300
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License Number State | NJ
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