Provider Demographics
NPI:1962990002
Name:RUTGERS-NJMS
Entity type:Organization
Organization Name:RUTGERS-NJMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VENKATRAMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THULASI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-533-4083
Mailing Address - Street 1:1417 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2256
Mailing Address - Country:US
Mailing Address - Phone:484-526-5210
Mailing Address - Fax:866-568-6561
Practice Address - Street 1:1417 8TH AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-2256
Practice Address - Country:US
Practice Address - Phone:484-526-5210
Practice Address - Fax:866-568-6561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty