Provider Demographics
NPI:1033245311
Name:VODDI, SWETHA D (MD)
Entity Type:Individual
Prefix:
First Name:SWETHA
Middle Name:D
Last Name:VODDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 WHITEHORSE MERCERVILLE RD STE 219
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3835
Mailing Address - Country:US
Mailing Address - Phone:609-584-5150
Mailing Address - Fax:609-584-5144
Practice Address - Street 1:1401 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 219
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3835
Practice Address - Country:US
Practice Address - Phone:609-584-5150
Practice Address - Fax:609-584-5144
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245070207Q00000X
NJ25MA09566200207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02899916Medicaid
NJ0459119Medicare UPIN
NY02899916Medicaid
NY99A911Medicare PIN