| Etukuru Md Pc | |
|
1001 Center St Little Egg Harbor Twp NJ 08087-1347 | |
| (609) 296-9292 | |
| Not Available |
| Full Name | Etukuru Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1001 Center St, Little Egg Harbor Twp, New Jersey |
| Authorized Official Name and Position | Kasturi Etukuru (OWNER) |
| Authorized Official Contact | 7187026139 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Etukuru Md Pc 33 Preakness Dr Monroe NJ 08831-7711 Ph: (718) 702-6139 | Etukuru Md Pc 1001 Center St Little Egg Harbor Twp NJ 08087-1347 Ph: (609) 296-9292 |
| NPI Number | 1780449868 |
|---|---|
| Provider Enumeration Date | 02/16/2024 |
| Last Update Date | 10/07/2024 |
| Medicare PECOS PAC ID | 0941647903 |
|---|---|
| Medicare Enrollment ID | O20240326002491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780449868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kasturi Etukuru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912117300 PECOS PAC ID: 3870688609 Enrollment ID: I20151023001552 |
Innout Urology Office Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1387 Route 539 Unit 2c, Little Egg Harbor Twp, NJ 08087 Phone: 888-433-9360 Fax: 609-355-4777 |