Provider Demographics
NPI:1548354822
Name:AYYALA, GIRIJA SOMAYAJULA (RD)
Entity type:Individual
Prefix:MRS
First Name:GIRIJA
Middle Name:SOMAYAJULA
Last Name:AYYALA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 RUE CHAGALL
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-6479
Mailing Address - Country:US
Mailing Address - Phone:631-495-3207
Mailing Address - Fax:
Practice Address - Street 1:59 RUE CHAGALL
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-6479
Practice Address - Country:US
Practice Address - Phone:631-495-3207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000673133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
270000673NY01OtherANTHEM HEALTH OF NY
A200235OtherMDNY
P846271OtherOXFORD
00067301OtherSUFFOLK HEALTH PLAN
1000042205OtherAFFINITY
NY19624POtherHIP HEALTH CARE PLANS NY
03P131OtherMEDICARE
4620954004OtherCIGNA HEALTH CARE OF NY
20590OtherUYTRA HEALTH PLAN
000673SOtherHEALTH CARE PARTNERS MSO
1209070OtherUNITED HEALTH CARE
101621585086611OtherAETNA US HEALTHCARE
03P131OtherMEDICARE