Provider Demographics
NPI:1255495123
Name:NADIPURAM, CHANDRIKA (MD)
Entity type:Individual
Prefix:DR
First Name:CHANDRIKA
Middle Name:
Last Name:NADIPURAM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1088 HIGHWAY 34
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-1948
Mailing Address - Country:US
Mailing Address - Phone:848-863-6621
Mailing Address - Fax:
Practice Address - Street 1:1088 HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-1948
Practice Address - Country:US
Practice Address - Phone:848-863-6621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0505172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2084P0800XOtherTAXONOMY
NJ451918C2DOtherLEGACYID/SFX
NJNA451918OtherMEDITRAKID
NJ451918C2DOtherLEGACYID/SFX