Provider Demographics
NPI:1275546160
Name:YERRAMILLI, RAMALAKSHMI VENKATA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMALAKSHMI
Middle Name:VENKATA
Last Name:YERRAMILLI
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 1:345 LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-3421
Mailing Address - Country:US
Mailing Address - Phone:732-246-7171
Mailing Address - Fax:732-246-8974
Practice Address - Street 1:345 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3421
Practice Address - Country:US
Practice Address - Phone:732-246-7171
Practice Address - Fax:732-246-8974
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04111200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1705709Medicaid