Provider Demographics
NPI:1114174687
Name:YANGALA, SRIDEVI (MD)
Entity Type:Individual
Prefix:DR
First Name:SRIDEVI
Middle Name:
Last Name:YANGALA
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 1:2500 ENGLISH CREEK AVE.
Mailing Address - Street 2:BLDG 1000, STE 1002
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234
Mailing Address - Country:US
Mailing Address - Phone:609-407-2310
Mailing Address - Fax:609-407-2311
Practice Address - Street 1:2500 ENGLISH CREEK AVE.
Practice Address - Street 2:BLDG 1000, STE 1002
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234
Practice Address - Country:US
Practice Address - Phone:609-407-2310
Practice Address - Fax:609-407-2311
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO8466300207R00000X
NJ25MA08466300208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine