Provider Demographics
NPI:1841503042
Name:NIRGUDKAR, ANJALEE SRIRAM (PH D, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:ANJALEE
Middle Name:SRIRAM
Last Name:NIRGUDKAR
Suffix:
Gender:F
Credentials:PH D, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046-1327
Mailing Address - Country:US
Mailing Address - Phone:617-877-9757
Mailing Address - Fax:
Practice Address - Street 1:50 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046-1327
Practice Address - Country:US
Practice Address - Phone:617-877-9757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst