Provider Demographics
NPI:1528260064
Name:PRADHAN, ANUJA A (MD)
Entity type:Individual
Prefix:
First Name:ANUJA
Middle Name:A
Last Name:PRADHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 GRAND COVE WAY
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-7223
Mailing Address - Country:US
Mailing Address - Phone:917-640-0220
Mailing Address - Fax:810-258-5228
Practice Address - Street 1:31 GRAND COVE WAY
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-7223
Practice Address - Country:US
Practice Address - Phone:917-640-0220
Practice Address - Fax:810-258-5228
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269458207RI0200X
NJ25MA095407000207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease