1780733998 NPI number — RAMALAKSHMI V. YERRAMILLI

Table of content: (NPI 1780733998)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780733998 NPI number — RAMALAKSHMI V. YERRAMILLI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAMALAKSHMI V. YERRAMILLI
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780733998
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
345 LIVINGSTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BRUNSWICK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08901-3421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-246-7171
Provider Business Mailing Address Fax Number:
732-246-8974

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
345 LIVINGSTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BRUNSWICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08901-3421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-246-7171
Provider Business Practice Location Address Fax Number:
732-246-8974
Provider Enumeration Date:
01/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YERRAMILLI
Authorized Official First Name:
RAMALAKSHMI
Authorized Official Middle Name:
V
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
732-246-7171

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  25MA04111200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1705709 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 13333 . This is a "AMERICAID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4094178 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 10627 . This is a "UHP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1018777 . This is a "NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: LP004 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0009570 . This is a "GHI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 01000134000 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 38619 . This is a "UNITEDHEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 509090 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: OK7975 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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