Provider Demographics
NPI:1467508309
Name:YALLA, RAJYALAKSHMI (MD,)
Entity Type:Individual
Prefix:DR
First Name:RAJYALAKSHMI
Middle Name:
Last Name:YALLA
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 1:62 LAKEVIEW ST
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1722
Mailing Address - Country:US
Mailing Address - Phone:201-880-6537
Mailing Address - Fax:201-880-6537
Practice Address - Street 1:62 LAKEVIEW ST
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1722
Practice Address - Country:US
Practice Address - Phone:201-880-6537
Practice Address - Fax:201-880-6537
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208444207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine