MRS. SOWMINI MEDAVARAM (NPI# 1255775987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255775987 |
| Entity Type | Individual |
| Full Name | MRS. SOWMINI MEDAVARAM |
| Credential | MBBS |
| Practice Address |
201 Lyons Ave Newark NJ 07112-2027 |
| Practice Telephone | 7325403579 |
| Mailing Telephone | 7325403579 |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
201 LYONS AVE |
| City | NEWARK |
| State | NJ |
| Zip Code | 07112-2027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982607149 | Dong Chen | Anesthesiology | 201 Lyons Ave, Newark, NJ 07112-2027 | 2005-05-23 |
| 1558962100 | Chris Kemen | Student in an Organized Health Care Education/Training Program | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-11-02 |
| 1275132904 | Special LLC | Emergency Medicine | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-10-23 |
| 1326646019 | University Medical Associates (om) | Internal Medicine | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-10-14 |
| 1063010742 | University Pediatric Associates (om) | Pediatrics | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-10-14 |
| 1932716586 | University Physician Associates of New Jersey, Inc. | Pediatrics | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-09-28 |
| 1225642200 | Cresencia E Leopold | Nurse Practitioner | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-09-07 |
| 1538786546 | Uri Netanel Schneider | Student in an Organized Health Care Education/Training Program | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-06-25 |
| 1275158032 | Nneka E Emenaka | Nurse Practitioner | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-06-08 |
| 1447874151 | Sarah Karron | Student in an Organized Health Care Education/Training Program | 201 Lyons Ave, Newark, NJ 07112-2027 | 2020-05-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129680 | Kimberly Sjockeia Smith-jones | Massage Therapist | 590 Irvine Turner Blvd, Newark, NJ 07112 | 2020-09-18 |
| 1346880325 | Latifat Olabisi Bamgbose | Licensed Practical Nurse | 233 Lehigh Avenue, #3, Newark, NJ 07112 | 2020-01-08 |
| 1316588122 | Leila Renee Grubbs | Counselor | 140 Chancellor Avenue, 1b, Newark, NJ 07112 | 2019-10-02 |
| 1891347225 | Obeng Pharmacy LLC | Pharmacy | 431-433 Elizabeth Avenue, Newark, NJ 07112 | 2019-07-16 |
| 1124595723 | Patience Marks | Nurse Practitioner | 15 Shaw Avenue, Newark, NJ 07112 | 2018-11-01 |
| 1215425145 | Johnbosco Okpala | Student in an Organized Health Care Education/Training Program | Nbimc 201 Lyons Ave, Newark, NJ 07112 | 2018-04-26 |
| 1700383809 | Big Sam's Services LLC | Home Health | 349 Hawthorne Avenue, Newark, NJ 07112 | 2018-04-06 |
| 1780117325 | Vivien Wai Tung Ku | Student in an Organized Health Care Education/Training Program | 201 Lyons Ave, Newark Beth Israel Medical Center, Department of Dentistry, Newark, NJ 07112 | 2017-04-11 |
| 1265839922 | Bhavinkumar Shah | Pharmacist | 178-180 Lyons Ave, Newark, NJ 07112 | 2014-11-24 |
| 1629377445 | Isaac Abiola Popoola | Registered Nurse | 357 Schley Aptb4, Newark, NJ 07112 | 2011-03-18 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477165959 | Nikolina Markovic | Student in an Organized Health Care Education/Training Program | 140 Bergen St # I121, Newark, NJ 07103-2425 | 2020-08-17 |
| 1770191413 | Matthias Dunse | Student in an Organized Health Care Education/Training Program | 90 Bergen St # 5200, Newark, NJ 07103-2425 | 2020-07-20 |
| 1659998805 | Alejandra Lazaro | Student in an Organized Health Care Education/Training Program | 35982 Burning Tree Dr, Newark, CA 94560-1530 | 2020-07-02 |
| 1912524968 | Tyson Mellish Anthony | Student in an Organized Health Care Education/Training Program | 185 S Orange Ave Bldg G595, Newark, NJ 07103-2757 | 2020-06-25 |
| 1891319646 | Mary Thi Tran | Student in an Organized Health Care Education/Training Program | 6230 Smith Ave, Newark, CA 94560-4541 | 2020-06-07 |
| 1891319638 | Onoyom O Onyile | Student in an Organized Health Care Education/Training Program | 110 Bergen St Rm C-723, Newark, NJ 07103-2495 | 2020-06-07 |
| 1235750936 | Dave Arnanth Thiyagaram | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave Medical Science Building, Suite G, Newark, NJ 07103-2757 | 2020-05-04 |
| 1619597093 | Naana Boachie | Student in an Organized Health Care Education/Training Program | 11 7th Ave Apt 5c, Newark, NJ 07104-3303 | 2020-04-25 |
| 1447870480 | Hadeel Samy Sadek | Student in an Organized Health Care Education/Training Program | 150 Bergen St # Uhi248, Newark, NJ 07103-2496 | 2020-04-20 |
| 1225657836 | Deneshia Mcintosh | Student in an Organized Health Care Education/Training Program | 185 S Orange Ave Bldg G594, Newark, NJ 07103-2757 | 2020-04-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.