Provider Demographics
NPI:1396056875
Name:NAGULA, SHREYA MANIAR (MD)
Entity type:Individual
Prefix:DR
First Name:SHREYA
Middle Name:MANIAR
Last Name:NAGULA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:STONY BROOK CHILDRENS SERVICES UFPC
Mailing Address - Street 2:HSC LEVEL 11 ROOM 080
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-444-2730
Mailing Address - Fax:
Practice Address - Street 1:37 RESEARCH WAY
Practice Address - Street 2:STONY BROOK CHILDRENS SERVICES
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3465
Practice Address - Country:US
Practice Address - Phone:631-444-2730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2524782084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry