Provider Demographics
NPI:1982858361
Name:KANUGA, DHARMISHTHA JAYESH
Entity Type:Individual
Prefix:
First Name:DHARMISHTHA
Middle Name:JAYESH
Last Name:KANUGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 THISTLE LN
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1200
Mailing Address - Country:US
Mailing Address - Phone:732-275-9001
Mailing Address - Fax:
Practice Address - Street 1:6 THISTLE LN
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1200
Practice Address - Country:US
Practice Address - Phone:732-275-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03661700207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology