Provider Demographics
NPI:1760710420
Name:REMEDY MEDICAL GROUP PC
Entity Type:Organization
Organization Name:REMEDY MEDICAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:YANGALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-463-2755
Mailing Address - Street 1:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0056
Mailing Address - Country:US
Mailing Address - Phone:609-463-2755
Mailing Address - Fax:
Practice Address - Street 1:219 SCHOOL HOUSE DR
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1644
Practice Address - Country:US
Practice Address - Phone:609-463-2755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA079160002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty