Provider Demographics
NPI:1821006065
Name:DAS, KAMALA (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMALA
Middle Name:
Last Name:DAS
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 1:170 CHANGE BRIDGE RD
Mailing Address - Street 2:B6
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045
Mailing Address - Country:US
Mailing Address - Phone:973-227-8898
Mailing Address - Fax:973-227-4633
Practice Address - Street 1:170 CHANGE BRIDGE RD
Practice Address - Street 2:B6
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045
Practice Address - Country:US
Practice Address - Phone:973-227-4633
Practice Address - Fax:973-227-4633
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA49689207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
571035Medicare ID - Type Unspecified
G07785Medicare UPIN