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General NPI Number Information
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NPI Number | 1821276015
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Entity Type | Individual
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Provider Name | VAKULA DEVI ATTHOTA M.D.,
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Gender | Female
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Dates
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Enumeration Date | 02/10/2008
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Last Update Date | 05/31/2019
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Provider Practice Location Address
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Address Line | 1450 E CHESTNUT AVE BLDG 3 SUITE A
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City | VINELAND
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State | NJ
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Zip | 08361-8467
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Country | US
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Telephone | 856-794-8700
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Fax | 856-794-2752
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Provider Business Mailing Address
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Address Line | 1450 E CHESTNUT AVE BLDG 3 SUITE A
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City | VINELAND
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State | NJ
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Zip | 08361-8467
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Country | US
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Telephone | 856-794-8700
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Fax | 856-794-2752
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA08958800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 25MA08958800
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License Number State | NJ
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