Provider Demographics
NPI:1912519059
Name:VAZHAPPILLY, ANU (NP)
Entity Type:Individual
Prefix:
First Name:ANU
Middle Name:
Last Name:VAZHAPPILLY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 CENTRAL PARK AVE APT E3
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1363
Mailing Address - Country:US
Mailing Address - Phone:914-202-5014
Mailing Address - Fax:
Practice Address - Street 1:356 CENTRAL PARK AVE APT E3
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1363
Practice Address - Country:US
Practice Address - Phone:914-202-5014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF403078163WP0808X, 363LP0808X
NYF403078-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty