Provider Demographics
NPI:1649348202
Name:ANANTHAPADMANABHA, UMA DEVI (MD)
Entity type:Individual
Prefix:DR
First Name:UMA DEVI
Middle Name:
Last Name:ANANTHAPADMANABHA
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 1:15 WHITE OAK DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006
Mailing Address - Country:US
Mailing Address - Phone:973-228-7515
Mailing Address - Fax:
Practice Address - Street 1:1111 PUGSLEY AVENUE
Practice Address - Street 2:JR HS IS 125 MORRISANIA SCHOOL BASED CLINIC
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472
Practice Address - Country:US
Practice Address - Phone:718-518-7882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150174208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics