Provider Demographics
NPI:1417904509
Name:MAHALINGHAM, BANU (MD)
Entity Type:Individual
Prefix:DR
First Name:BANU
Middle Name:
Last Name:MAHALINGHAM
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 1:731 ALEXANDER RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6345
Mailing Address - Country:US
Mailing Address - Phone:609-921-7456
Mailing Address - Fax:906-921-2972
Practice Address - Street 1:731 ALEXANDER RD
Practice Address - Street 2:SUITE 202
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6345
Practice Address - Country:US
Practice Address - Phone:609-921-7456
Practice Address - Fax:906-921-2972
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA68798174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
F1K9429OtherHEALTHNET
141191OtherGHI
F1K9429OtherGUARDIAN
NJ2106944OtherUNITEDHEALTHCARE
NJ8572607Medicaid
NJ1306445OtherAMERIHEALTH PPO
NJ060066850OtherRAILROAD MEDICARE
NJ2676007OtherAETNA
NJ3142106002OtherCIGNA
F1K9429OtherADVANTAGE PLATINUM
NJP2461106OtherOXFORD
0973447000OtherAMERIHEALTH
NJ8572607Medicaid
NJ060066850Medicare PIN
NJ3142106002OtherCIGNA