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General NPI Number Information
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NPI Number | 1902245954
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Entity Type | Individual
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Provider Name | LAKSHMI PRIYA NULU MD, FAAP
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Gender | Female
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 04/01/2014
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Provider Practice Location Address
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Address Line | 660 E 98TH ST APT 7B
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City | BROOKLYN
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State | NY
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Zip | 11236-1356
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Country | US
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Telephone | 718-916-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 751 E 16TH ST SUITE 400
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City | BERWICK
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State | PA
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Zip | 18603-2321
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Country | US
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Telephone | 718-916-1200
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD449059
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License Number State | PA
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