NOAH PRAVEEN KUMAR KONDAMUDI M.D. NPI 1114958451

NPI Information

NPI: 1114958451
Provider Name: NOAH PRAVEEN KUMAR KONDAMUDI, M.D.
Classification: Pediatrics - 2080P0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
30 BERGEN ST
ADMC 12 1205
NEWARK, NJ
ZIP 07107
Phone: (973) 972-0037
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Noah Praveen Kumar Kondamudi, M.D. is a pediatric emergency medicine pediatrics in Newark, NJ. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. Noah Praveen Kumar Kondamudi, M.D. NPI is 1114958451. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

30 BERGEN ST
ADMC 12 1205
NEWARK, NJ
ZIP 07107-000
Phone: (973) 972-0037

The NPI 1114958451 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/5/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080P0204X	Pediatrics	Pediatric Emergency Medicine	25MA06802600	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	8778205	MEDICAID	NEW JERSEY
2	G43523	MEDICARE UPIN
3	059507	MEDICARE ID-TYPE UNSPECIFIED	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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