Provider Demographics
NPI:1396855854
Name:NANDAKUMAR, RAJALAKSHMI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJALAKSHMI
Middle Name:
Last Name:NANDAKUMAR
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:KNOLLCROFT RD
Mailing Address - Street 2:VA NJHCS - DEPT AMBULATORY CARE
Mailing Address - City:LYONS
Mailing Address - State:NJ
Mailing Address - Zip Code:07939
Mailing Address - Country:US
Mailing Address - Phone:908-647-0180
Mailing Address - Fax:908-647-6367
Practice Address - Street 1:KNOLLCROFT RD
Practice Address - Street 2:VA NJHCS - DEPT AMBULATORY CARE
Practice Address - City:LYONS
Practice Address - State:NJ
Practice Address - Zip Code:07939
Practice Address - Country:US
Practice Address - Phone:908-647-0180
Practice Address - Fax:908-647-6367
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA03809200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine