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General NPI Number Information
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NPI Number | 1073577870
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Entity Type | Individual
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Provider Name | NIRMALA DEVI SANAKKAYALA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 717 N BEERS ST SUITE 2F
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City | HOLMDEL
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State | NJ
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Zip | 07733-1524
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Country | US
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Telephone | 732-264-3442
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Fax | 732-264-0973
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Provider Business Mailing Address
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Address Line | 717 N BEERS ST SUITE 2F
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City | HOLMDEL
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State | NJ
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Zip | 07733-1524
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Country | US
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Telephone | 732-264-3442
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Fax | 732-264-0973
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA03132700
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License Number State | NJ
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