Provider Demographics
NPI:1740407600
Name:VANAJA ASSOCIATES MD,P.C
Entity Type:Organization
Organization Name:VANAJA ASSOCIATES MD,P.C
Other - Org Name:KURRA ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ATTENDING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:VANAJAKSHI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATURU
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:201-952-3377
Mailing Address - Street 1:15 LA ROSA DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-1724
Mailing Address - Country:US
Mailing Address - Phone:201-229-9589
Mailing Address - Fax:
Practice Address - Street 1:15-01 BROADWAY
Practice Address - Street 2:SUITE 10 - B
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-6003
Practice Address - Country:US
Practice Address - Phone:201-794-7733
Practice Address - Fax:201-794-6039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0703412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8787808Medicaid
NJ8787808Medicaid
NJ043652DMSMedicare ID - Type Unspecified