Provider Demographics
NPI:1538395637
Name:HEMATOLOGY ONCOLOGY CONSULTANTS LLC
Entity type:Organization
Organization Name:HEMATOLOGY ONCOLOGY CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEAULA
Authorized Official - Middle Name:V
Authorized Official - Last Name:KODURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-483-4501
Mailing Address - Street 1:PO BOX 1177
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-9177
Mailing Address - Country:US
Mailing Address - Phone:732-483-4501
Mailing Address - Fax:732-483-4502
Practice Address - Street 1:2110 OAK TREE ROAD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3626
Practice Address - Country:US
Practice Address - Phone:732-483-4501
Practice Address - Fax:732-483-4502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA081586207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty