Provider Demographics
NPI:1871523910
Name:SABNANI- NAGELLA, KAVITA R (MD)
Entity type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:R
Last Name:SABNANI- NAGELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1426
Mailing Address - Country:US
Mailing Address - Phone:973-822-2000
Mailing Address - Fax:973-822-2001
Practice Address - Street 1:10 JAMES ST
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1426
Practice Address - Country:US
Practice Address - Phone:973-822-2000
Practice Address - Fax:973-822-2001
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07456000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ072221Medicare ID - Type Unspecified
NJH05501Medicare UPIN