Provider Demographics
NPI:1679795835
Name:BUDHWANI, ANJU (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJU
Middle Name:
Last Name:BUDHWANI
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 1:166 MAIN ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07035-1791
Mailing Address - Country:US
Mailing Address - Phone:973-694-6260
Mailing Address - Fax:973-694-2359
Practice Address - Street 1:166 MAIN ST STE 1A
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:NJ
Practice Address - Zip Code:07035
Practice Address - Country:US
Practice Address - Phone:973-694-6260
Practice Address - Fax:973-694-2359
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07469200207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0216119Medicaid
NJ125069OtherMEDICARE
NJ125069Medicare PIN