Provider Demographics
NPI:1356492433
Name:GADIYARAM, MADHURI DEVI (MD)
Entity Type:Individual
Prefix:DR
First Name:MADHURI
Middle Name:DEVI
Last Name:GADIYARAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:826 TERNAY AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-2150
Mailing Address - Country:US
Mailing Address - Phone:813-481-9467
Mailing Address - Fax:908-262-2195
Practice Address - Street 1:390 AMWELL RD STE 204
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1244
Practice Address - Country:US
Practice Address - Phone:082-622-1979
Practice Address - Fax:908-262-2195
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY242255207R00000X
NJ25MA09756200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400158419Medicare PIN