Provider Demographics
NPI:1225074701
Name:POTLURI, HARITHA (MD)
Entity Type:Individual
Prefix:DR
First Name:HARITHA
Middle Name:
Last Name:POTLURI
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 1:38 HERITAGE WAY
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-5822
Mailing Address - Country:US
Mailing Address - Phone:732-820-0088
Mailing Address - Fax:732-719-2224
Practice Address - Street 1:1440 HOW LN
Practice Address - Street 2:SUITE 2D
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4600
Practice Address - Country:US
Practice Address - Phone:732-719-2222
Practice Address - Fax:732-719-2224
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08083800207R00000X, 207RC0200X, 207RP1001X
NJMA08083800207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine