Healthcare Provider Details

I. General information

NPI: 1619660321
Provider Name (Legal Business Name): PRAAKRUTI CHERUKURI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 US HIGHWAY 206
HILLSBOROUGH NJ
08844-4142
US

IV. Provider business mailing address

71 US HIGHWAY 206
HILLSBOROUGH NJ
08844-4142
US

V. Phone/Fax

Practice location:
  • Phone: 908-685-1887
  • Fax: 908-685-0162
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA13182900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: