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NPI Code Detail

MEDICARE: VANITHA YADALLA MD LLC

MEDICARE: VANITHA YADALLA MD LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) Physician
2207RH0005XHypertension Specialist Physician
3363L00000XNurse Practitioner
4363LW0102XWomen's Health Nurse Practitioner
5363LA2200XAdult Health Nurse Practitioner
6363LF0000XFamily Nurse Practitioner
7363LP2300XPrimary Care Nurse Practitioner
8363LX0106XOccupational Health Nurse Practitioner
9207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1326200361
Entity Type Code : Organization
Provider Name (Legal Business Name) : VANITHA YADALLA MD LLC
Provider Business Mailing Address
First Line : 3350 STATE ROUTE 138 STE 117
Second Line :
City : WALL TOWNSHIP
State : NJ
Zip : 07719-9694
Country : US
Telephone Number : 732-280-2727
Fax Number : 732-280-1147
Provider Business Practice Location Address
First Line : 3350 STATE ROUTE 138 STE 117
Second Line :
City : WALL TOWNSHIP
State : NJ
Zip : 07719-9694
Country : US
Telephone Number : 732-280-2727
Fax Number : 732-280-1147
Authorized Official
Title or Position : OWNER
Name : VANITHA YADALLA
Credential : MD
Telephone Number : 732-280-2727
Provider Enumeration Date : 07/01/2008
Last Update Date : 07/17/2025

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Directions to “VANITHA YADALLA MD LLC ” Practice Location

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