Provider Demographics
NPI:1356517593
Name:VENKATRAMAN, GUHA K (MD)
Entity type:Individual
Prefix:DR
First Name:GUHA
Middle Name:K
Last Name:VENKATRAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:340 E NORTHFIELD RD STE 1B
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4892
Mailing Address - Country:US
Mailing Address - Phone:973-255-8920
Mailing Address - Fax:973-500-4411
Practice Address - Street 1:340 E NORTHFIELD RD STE 1B
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4892
Practice Address - Country:US
Practice Address - Phone:973-255-8920
Practice Address - Fax:973-500-4411
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1533292084N0400X
NH221242084N0400X
MT1099672084N0400X
NJ25MA088831002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology