Provider Demographics
NPI:1083714273
Name:AYYANATHAN, KARPUKARASI (MD)
Entity Type:Individual
Prefix:MRS
First Name:KARPUKARASI
Middle Name:
Last Name:AYYANATHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 RAHWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-2308
Mailing Address - Country:US
Mailing Address - Phone:908-527-1247
Mailing Address - Fax:908-354-8822
Practice Address - Street 1:517 RAHWAY AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-2308
Practice Address - Country:US
Practice Address - Phone:908-527-1247
Practice Address - Fax:908-354-8822
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA35801208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3048900Medicaid
NJ003Medicare UPIN
NJ39F87Medicare UPIN
NJ0K2073Medicare UPIN
NJ2699315Medicare UPIN
NJ324181Medicare UPIN
NJ4093468Medicare UPIN
NJ12598Medicare UPIN
NJJ5764Medicare UPIN
NJUP012Medicare UPIN
NJ3048900Medicaid
NJ0464332001Medicare UPIN