| Organization Name: | SURESHBABU KURRA MD LLC |
| NPI Number: | 1093046807 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SURESHBABU KURRA (PRESIDENT) |
| Mailing Address: | 7 Hyde Park Pl Sparta |
| State: | NJ US |
| Postal Code: | 078711152 |
| Phone Number: | 2012134021 |
| Fax Number: | |
| NPI Enumeration Date: | 01/18/2010 |
| NPI Last Update Date: | 01/18/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 40442 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |