Provider Demographics
NPI:1437176880
Name:VELAYADIKOT, DEEPA (MD)
Entity Type:Individual
Prefix:
First Name:DEEPA
Middle Name:
Last Name:VELAYADIKOT
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 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:THE COOPER HOSPITALIST TEAM
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-3150
Practice Address - Fax:856-968-8418
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07155100207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P3737072OtherOXFORD
PA1352655OtherPA BLUE SHIELD
1104234OtherCIGNA
2165652OtherUNITED HEALTHCARE
3K6200OtherHEALTHNET
P00400176OtherRR MEDICARE
01000542001OtherAMERICHOICE
41071OtherUNIVERSITY HEALTHPLAN
1448496OtherAETNA
2045126000OtherAMERIHEALTH HMO, PPO, KEYSTONE
NJ8533008Medicaid
1448496OtherAETNA
NJ8533008Medicaid