Provider Demographics
NPI:1093731648
Name:NAGULAPALLI, CHAITANYA (MD)
Entity Type:Individual
Prefix:
First Name:CHAITANYA
Middle Name:
Last Name:NAGULAPALLI
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 1:2 MILLSTONE CT
Mailing Address - Street 2:
Mailing Address - City:CRANBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08512-2006
Mailing Address - Country:US
Mailing Address - Phone:609-613-5132
Mailing Address - Fax:
Practice Address - Street 1:2 MILLSTONE CT
Practice Address - Street 2:
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512-2006
Practice Address - Country:US
Practice Address - Phone:973-997-1472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07992100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ47915-NON PAR#OtherUHP
NJ0102431Medicaid
NJP00689256-MERCEROtherRAILROAD MEDICARE
NJP00689256-MERCEROtherRAILROAD MEDICARE
NJ100525XPFMedicare PIN
NJI25011Medicare UPIN