Provider Demographics
NPI:1548602600
Name:MEGA HEALTHCARE LLC
Entity Type:Organization
Organization Name:MEGA HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:MADHAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:PENTYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-489-6800
Mailing Address - Street 1:1 SCHANCK DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2417
Mailing Address - Country:US
Mailing Address - Phone:908-489-6800
Mailing Address - Fax:
Practice Address - Street 1:22 OLD SHORT HILLS RD
Practice Address - Street 2:SUITE 213
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5604
Practice Address - Country:US
Practice Address - Phone:973-544-6688
Practice Address - Fax:973-629-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-18
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07939700261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care