Provider Demographics
NPI:1336512490
Name:VASUDEVAN, PRIYA (MS)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:VASUDEVAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 GALLOPING HILL RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7989
Mailing Address - Country:US
Mailing Address - Phone:908-686-1505
Mailing Address - Fax:
Practice Address - Street 1:1000 GALLOPING HILL RD
Practice Address - Street 2:SUITE 301
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7989
Practice Address - Country:US
Practice Address - Phone:908-686-1505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst