Provider Demographics
NPI:1407027097
Name:RADHAKRISHNA, SUHAS (MD)
Entity Type:Individual
Prefix:DR
First Name:SUHAS
Middle Name:
Last Name:RADHAKRISHNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 STELTON RD
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3251
Mailing Address - Country:US
Mailing Address - Phone:732-354-9660
Mailing Address - Fax:833-397-1871
Practice Address - Street 1:155 STELTON RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3251
Practice Address - Country:US
Practice Address - Phone:732-354-9660
Practice Address - Fax:833-397-1871
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101007208000000X, 2080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics