| Prathibha Potharlanka Llc | |
|
30 Belmont Cir Columbus NJ 08022-9714 | |
| (856) 465-7728 | |
| Not Available |
| Full Name | Prathibha Potharlanka Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 30 Belmont Cir, Columbus, New Jersey |
| Authorized Official Name and Position | Prathibha Potharlanka (OWNER) |
| Authorized Official Contact | 8564657728 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prathibha Potharlanka Llc 30 Belmont Cir Columbus NJ 08022-9714 Ph: (650) 814-6563 | Prathibha Potharlanka Llc 30 Belmont Cir Columbus NJ 08022-9714 Ph: (856) 465-7728 |
| NPI Number | 1588353858 |
|---|---|
| Provider Enumeration Date | 05/03/2023 |
| Last Update Date | 10/27/2023 |
| Medicare PECOS PAC ID | 7416493937 |
|---|---|
| Medicare Enrollment ID | O20240722000014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588353858 | NPI | - | NPPES |
| Provider Name | Prathibha Potharlanka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295761690 PECOS PAC ID: 4587633862 Enrollment ID: I20041004000017 |
| Provider Name | Chinwe Emerah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912485871 PECOS PAC ID: 4183976269 Enrollment ID: I20230516001149 |
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