Provider Demographics
NPI:1598780371
Name:KAMALAKAR, PERI (MD)
Entity Type:Individual
Prefix:DR
First Name:PERI
Middle Name:
Last Name:KAMALAKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KAMALAKAR
Other - Middle Name:
Other - Last Name:PERI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:201 LYONS AVE
Mailing Address - Street 2:VALERIE FUND CHILDRENS CENTER
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2027
Mailing Address - Country:US
Mailing Address - Phone:973-926-7161
Mailing Address - Fax:973-282-0395
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:VALERIE FUND CHILDRENS CENTER
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-7161
Practice Address - Fax:973-282-0395
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA268312080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA26831OtherSTATE LICENSE
NJ09844OtherNCI INVESTIGATOR NUMBER
NJ1527606Medicaid
NJCDS D0242454OtherSTATE CDS NUMBER
NJCDS D0242454OtherSTATE CDS NUMBER
NJ09844OtherNCI INVESTIGATOR NUMBER
NJC53928Medicare UPIN