Healthcare Provider Details

I. General information

NPI: 1831109610
Provider Name (Legal Business Name): LEELA SADASHIV RAO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CONEFLOWER LN
WEST WINDSOR NJ
08550-2410
US

IV. Provider business mailing address

5 CONEFLOWER LN
WEST WINDSOR NJ
08550-2410
US

V. Phone/Fax

Practice location:
  • Phone: 609-443-8501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number30862
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101025623
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number169019-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number30862
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number0101025623
License Number StateVA
# 6
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number169019-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: