Tara P. Kanetkar, Md, Pa | |
2149 Woodbridge Ave Edison NJ 08817-4474 | |
(732) 985-2151 | |
(732) 985-0650 |
Full Name | Tara P. Kanetkar, Md, Pa |
---|---|
Speciality | Family Medicine |
Location | 2149 Woodbridge Ave, Edison, New Jersey |
Authorized Official Name and Position | Tara P Kanetkar (OWNER) |
Authorized Official Contact | 7329852151 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Tara P. Kanetkar, Md, Pa 2149 Woodbridge Ave Edison NJ 08817-4474 Ph: (732) 985-2151 | Tara P. Kanetkar, Md, Pa 2149 Woodbridge Ave Edison NJ 08817-4474 Ph: (732) 985-2151 |
NPI Number | 1326186768 |
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Provider Enumeration Date | 02/01/2007 |
Last Update Date | 09/20/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326186768 | NPI | - | NPPES |
2091704 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | MA023527 (New Jersey) | Primary |
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