Pentyala, Madhavi

Pentyala, Madhavi is an sole proprietor health care provider with primary practice located at 22 Old Short Hills Rd Suite 213, Livingston NJ 07039-5604. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Pentyala, Madhavi can be contacted via phone (973) 992-0658.

Contact Information

Primary practice address
22 Old Short Hills Rd Suite 213 Livingston NJ 07039-5604
Phone: (973) 992-0658
Fax: (973) 992-6655
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25MA07939700 New Jersey

Profile Details

NPI number 1265490072
LBN Legal business name Pentyala, Madhavi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 2nd, 2006
Last updated May 20th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265490072 NPPES
New Jersey MEDICAID 0079855

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