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General NPI Number Information
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NPI Number | 1750866869
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Entity Type | Individual
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Provider Name | ANJULI BODAPATI PHD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 608 SHERWOOD PKWY STE 2D
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092
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Country | US
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Telephone | 908-913-0462
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Fax |
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Provider Business Mailing Address
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Address Line | 306 WOODS END RD
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City | WESTFIELD
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State | NJ
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Zip | 07090-2908
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Country | US
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Telephone | 908-913-0462
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Fax |
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 022930
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 35S100620100
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License Number State | NJ
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