Provider Demographics
NPI:1902245954
Name:NULU, LAKSHMI PRIYA (MD, FAAP)
Entity Type:Individual
Prefix:DR
First Name:LAKSHMI
Middle Name:PRIYA
Last Name:NULU
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 E 16TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-2321
Mailing Address - Country:US
Mailing Address - Phone:718-916-1200
Mailing Address - Fax:
Practice Address - Street 1:660 E 98TH ST
Practice Address - Street 2:APT 7B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-1356
Practice Address - Country:US
Practice Address - Phone:718-916-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD449059208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics