Provider Demographics
NPI:1427071729
Name:KRISHNAIAH, MURALIDHAR (MD)
Entity type:Individual
Prefix:DR
First Name:MURALIDHAR
Middle Name:
Last Name:KRISHNAIAH
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1691 HIGWAY 9
Mailing Address - Street 2:CN 2025
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754
Mailing Address - Country:US
Mailing Address - Phone:732-914-3843
Mailing Address - Fax:732-914-0854
Practice Address - Street 1:1691 ROUTE 9
Practice Address - Street 2:SAINT BARBABAS BEHAVIORAL HEALTH CENTER CN 2025
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1245
Practice Address - Country:US
Practice Address - Phone:732-914-3843
Practice Address - Fax:732-914-3854
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA80230002084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0099341Medicaid