MEDICARE: MRS. SUREKHA ASHWIN JADHAV M.D.

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
1	208000000X	Pediatrics Physician	25MA09749400	NJ

General Provider Information

NPI Number	:	1164899704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUREKHA ASHWIN JADHAV M.D.

Provider Business Mailing Address
First Line	:	1553 RUTH RD
Second Line	:	ROUTE 1
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4075
Country	:	US
Telephone Number	:	732-418-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1553 RUTH RD
Second Line	:	ROUTE 1
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4075
Country	:	US
Telephone Number	:	732-418-1700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	08/31/2015

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