Provider Demographics
NPI:1487922118
Name:MAHI PEDIATRICS P.C.
Entity type:Organization
Organization Name:MAHI PEDIATRICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:UMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANIKCHARLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-252-8453
Mailing Address - Street 1:41 WILSON AVENUE
Mailing Address - Street 2:#2D
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105
Mailing Address - Country:US
Mailing Address - Phone:973-589-7337
Mailing Address - Fax:973-589-1905
Practice Address - Street 1:41 WILSON AVENUE
Practice Address - Street 2:#2D
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-3612
Practice Address - Country:US
Practice Address - Phone:732-252-8453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08291800208000000X
2080P0206X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty