Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 25MA10972000 | NJ |
N | 2086S0122X | Plastic and Reconstructive Surgery | 307678 | NY |
NPI | 1003105099 |
---|---|
Provider Name | Dr. Chaitan Devulapalli |
First Address | Maywood, NJ 07607-1023 |
Second Address | Maywood, NJ 07607-1023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2011 |
Last Update Date | 23/02/2021 |