MEDICARE: CENTER FOR INFECTIOUS DISEASES AND INTL. TRAVEL CARE OF MONMOUTH, P.C.

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	282N00000X	General Acute Care Hospital	25MA07472000	NJ
2	261QM2500X	Medical Specialty Clinic/Center	25MA07472000	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

General Provider Information

NPI Number	:	1497929038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR INFECTIOUS DISEASES AND INTL. TRAVEL CARE OF MONMOUTH, P.C.

Provider Business Mailing Address
First Line	:	31 YELLOW BROOK RD
Second Line	:
City	:	HOLMDEL
State	:	NJ
Zip	:	07733-1967
Country	:	US
Telephone Number	:	732-682-9763
Fax Number	:	732-631-9924

Provider Business Practice Location Address
First Line	:	901 WEST MAIN STREET SUITE 260,
Second Line	:	CN 5050,
City	:	FREEHOLD
State	:	NJ
Zip	:	07728
Country	:	US
Telephone Number	:	732-685-9243
Fax Number	:	732-631-9924

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RAMANASRI V. KUDIPUDI
Credential	:	M.D.
Telephone Number	:	732-685-9243

Provider Enumeration Date	:	04/15/2008
Last Update Date	:	04/16/2024

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