Provider Demographics
NPI:1568656270
Name:VERMA, MADHOOLIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:MADHOOLIKA
Middle Name:
Last Name:VERMA
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 1:15 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3555
Mailing Address - Country:US
Mailing Address - Phone:732-366-3234
Mailing Address - Fax:732-487-3373
Practice Address - Street 1:52 STATE ROUTE 27 STE 1A
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3982
Practice Address - Country:US
Practice Address - Phone:732-366-3234
Practice Address - Fax:732-487-3373
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJFV2419554207P00000X
NJ25MA08807200208000000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0305821Medicaid