Provider Demographics
NPI:1780733998
Name:RAMALAKSHMI V. YERRAMILLI
Entity type:Organization
Organization Name:RAMALAKSHMI V. YERRAMILLI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMALAKSHMI
Authorized Official - Middle Name:V
Authorized Official - Last Name:YERRAMILLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-246-7171
Mailing Address - Street 1:345 LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-3421
Mailing Address - Country:US
Mailing Address - Phone:732-246-7171
Mailing Address - Fax:732-246-8974
Practice Address - Street 1:345 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3421
Practice Address - Country:US
Practice Address - Phone:732-246-7171
Practice Address - Fax:732-246-8974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04111200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1705709Medicaid
NJ13333OtherAMERICAID
NJ4094178OtherAETNA
NJ10627OtherUHP
NJ1018777OtherNJ HEALTH
NJLP004OtherOXFORD
NJ0009570OtherGHI
NJ01000134000OtherAMERICHOICE
NJ38619OtherUNITEDHEALTHCARE
NJ509090OtherCIGNA
NJOK7975OtherHEALTHNET