Provider Demographics
NPI:1891893541
Name:PASUPULETI, RAO S (MD)
Entity Type:Individual
Prefix:DR
First Name:RAO
Middle Name:S
Last Name:PASUPULETI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1245 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE 415
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3831
Mailing Address - Country:US
Mailing Address - Phone:609-585-2666
Mailing Address - Fax:609-585-4008
Practice Address - Street 1:1245 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 415
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3831
Practice Address - Country:US
Practice Address - Phone:609-585-2666
Practice Address - Fax:609-585-4008
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-04-09
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA041076002084N0400X, 2084N0402X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1399101Medicaid
NJD92579Medicare UPIN
NJ1399101Medicaid