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22 Old Short Hills Rd Suite #108 Livingston NJ 07039-5604 | |
| (973) 535-5227 | |
| (973) 535-3406 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 22 Old Short Hills Rd, Livingston, New Jersey |
| Authorized Official Name and Position | Vani Maddali (M.D) |
| Authorized Official Contact | 9735355227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
29 Springfield Ct Parsippany NJ 07054-2943 Ph: (973) 316-5820 | 22 Old Short Hills Rd Suite #108 Livingston NJ 07039-5604 Ph: (973) 535-5227 |
| NPI Number | 1073688958 |
|---|---|
| Provider Enumeration Date | 11/23/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073688958 | NPI | - | NPPES |
| 8522600 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MA07029100 (New Jersey) | Primary |
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