Provider Demographics
NPI:1891769527
Name:PALVAI, PADMA (MD)
Entity Type:Individual
Prefix:
First Name:PADMA
Middle Name:
Last Name:PALVAI
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 1:15 W HIGH ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2103
Mailing Address - Country:US
Mailing Address - Phone:908-366-7862
Mailing Address - Fax:
Practice Address - Street 1:15 W HIGH ST UNIT A
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2103
Practice Address - Country:US
Practice Address - Phone:908-366-7862
Practice Address - Fax:908-928-7868
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-017662084P0800X, 2084P0804X
NJ25MA079512002084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0078255Medicaid
NC1891769527Medicaid
NJI44248Medicare UPIN