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NPI Code Detail

MEDICARE: GOVIDAMMAL SUBRAMANIAN MD

MEDICARE: GOVIDAMMAL SUBRAMANIAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician25MA04433400NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154357101
Entity Type Code : Individual
Provider Name (Legal Business Name) : GOVIDAMMAL SUBRAMANIAN MD
Provider Business Mailing Address
First Line : 1700 MYRTLE AVE
Second Line :
City : PLAINFIELD
State : NJ
Zip : 07063-1000
Country : US
Telephone Number : 908-753-6401
Fax Number : 908-226-6743
Provider Business Practice Location Address
First Line : 1700 MYRTLE AVE
Second Line :
City : PLAINFIELD
State : NJ
Zip : 07063-1000
Country : US
Telephone Number : 908-753-6401
Fax Number : 908-226-6743
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 02/28/2013

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