Provider Demographics
NPI:1073596276
Name:YELLAYI, PRIYA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:A
Last Name:YELLAYI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PRIYA
Other - Middle Name:
Other - Last Name:AKELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1075 STEPHENSON AVENUE
Mailing Address - Street 2:PATTERSON ARMY HEALTH CLINIC
Mailing Address - City:FORT MONMOUTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07703-5000
Mailing Address - Country:US
Mailing Address - Phone:732-532-0182
Mailing Address - Fax:732-532-0194
Practice Address - Street 1:1075 STEPHENSON AVENUE
Practice Address - Street 2:PATTERSON ARMY HEALTH CLINIC
Practice Address - City:FORT MONMOUTH
Practice Address - State:NJ
Practice Address - Zip Code:07703-5000
Practice Address - Country:US
Practice Address - Phone:732-532-0182
Practice Address - Fax:732-532-0194
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA065397207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine