Provider Demographics
NPI:1841207578
Name:MAMIDI ARUNIMA MD LLC
Entity Type:Organization
Organization Name:MAMIDI ARUNIMA MD LLC
Other - Org Name:PRINCETON INFECTIOUS DISEASES ASSOCIATES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ARUNIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAMIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-371-4666
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:BLAWENBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08504
Mailing Address - Country:US
Mailing Address - Phone:609-371-4666
Mailing Address - Fax:609-443-4800
Practice Address - Street 1:5 PLAINSBORO ROAD
Practice Address - Street 2:SUITE 360
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-1913
Practice Address - Country:US
Practice Address - Phone:609-750-0011
Practice Address - Fax:609-750-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA068633207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P3316946OtherOXFORD
J31841OtherHEALTHNET
2232008001OtherKEYSTONE
60006502OtherHORIZON NJ HEALTH
NJ7947607Medicaid
2232008001OtherKEYSTONE