MEDICARE: NAVATHA KURUGUNDLA 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	207RP1001X	Pulmonary Disease Physician	25MA08689400	NJ

General Provider Information

NPI Number	:	1497999544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAVATHA KURUGUNDLA MD

Provider Business Mailing Address
First Line	:	1315 WHITEHORSE MERCERVILLE RD STE 100
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08619-3815
Country	:	US
Telephone Number	:	609-853-7272
Fax Number	:	608-853-7271

Provider Business Practice Location Address
First Line	:	1315 WHITEHORSE MERCERVILLE RD STE 100
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08619-3815
Country	:	US
Telephone Number	:	609-853-7272
Fax Number	:	609-853-7271

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

Provider Enumeration Date	:	04/20/2009
Last Update Date	:	05/03/2021

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