MEDICARE: RAMALAKSHMI K. NUTHI 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
1	207Q00000X	Family Medicine Physician	25MA08494900	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	248860	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1306007133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAMALAKSHMI K. NUTHI MD

Provider Business Mailing Address
First Line	:	1 DIAMOND HILL RD
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-2104
Country	:	US
Telephone Number	:	908-273-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 ROUTE 35
Second Line	:
City	:	WALL TOWNSHIP
State	:	NJ
Zip	:	07719-3541
Country	:	US
Telephone Number	:	732-280-2600
Fax Number	:

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

Provider Enumeration Date	:	06/24/2008
Last Update Date	:	08/21/2020

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