Provider Demographics
NPI:1861562688
Name:ANANDAKRISHNAN, RAJASHREE (MD)
Entity type:Individual
Prefix:DR
First Name:RAJASHREE
Middle Name:
Last Name:ANANDAKRISHNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 FULD ST
Mailing Address - Street 2:STE 305
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-5247
Mailing Address - Country:US
Mailing Address - Phone:609-394-6338
Mailing Address - Fax:609-838-0689
Practice Address - Street 1:40 FULD ST
Practice Address - Street 2:STE 305
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638-5247
Practice Address - Country:US
Practice Address - Phone:609-394-6338
Practice Address - Fax:609-394-6328
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07556100207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5266106Medicaid
NJ5266106Medicaid