Provider Demographics
NPI:1790678753
Name:MIND AND BODY MEDICINE LLC
Entity type:Organization
Organization Name:MIND AND BODY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARUNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PODDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-659-1051
Mailing Address - Street 1:28 SAINT MORITZ LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-5122
Mailing Address - Country:US
Mailing Address - Phone:732-659-1051
Mailing Address - Fax:
Practice Address - Street 1:28 SAINT MORITZ LN
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-5122
Practice Address - Country:US
Practice Address - Phone:732-659-1051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty