Provider Demographics
NPI:1194942805
Name:KANDULA, SRIDEVI (MD)
Entity type:Individual
Prefix:
First Name:SRIDEVI
Middle Name:
Last Name:KANDULA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:331 NEWMAN SPRINGS RD STE 220
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5792
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:3 HOSPITAL PLZ STE 200
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3084
Practice Address - Country:US
Practice Address - Phone:732-360-4085
Practice Address - Fax:732-360-4086
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2009-0727207Q00000X
NJ25MA08844800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine