Bhoosamalliah,md | |
222 Jack Martin Blvd Suite. E, Bricktown NJ 08724-7772 | |
(732) 840-8688 | |
(732) 840-8480 |
Full Name | Bhoosamalliah,md |
---|---|
Speciality | Internal Medicine - Adolescent Medicine |
Location | 222 Jack Martin Blvd, Bricktown, New Jersey |
Authorized Official Name and Position | Bhoosa Malliah (PHYSICIAN) |
Authorized Official Contact | 7328408688 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Bhoosamalliah,md 222 Jack Martin Blvd Suite. E, Bricktown NJ 08724-7772 Ph: (732) 840-8688 | Bhoosamalliah,md 222 Jack Martin Blvd Suite. E, Bricktown NJ 08724-7772 Ph: (732) 840-8688 |
NPI Number | 1639145436 |
---|---|
Provider Enumeration Date | 02/23/2006 |
Last Update Date | 09/20/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639145436 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RA0000X | Internal Medicine - Adolescent Medicine | (* (Not Available)) | Primary |