Provider Demographics
NPI:1487691135
Name:KAIRAM, NEERAJA (MD)
Entity type:Individual
Prefix:DR
First Name:NEERAJA
Middle Name:
Last Name:KAIRAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NEERAJA
Other - Middle Name:
Other - Last Name:DANDAMUDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:651 WEST MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-740-0607
Mailing Address - Fax:973-740-9895
Practice Address - Street 1:651 WEST MOUNT PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039
Practice Address - Country:US
Practice Address - Phone:973-740-0607
Practice Address - Fax:973-740-9895
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA71940207P00000X
NJ25MA07194000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8742006Medicaid
NJ8742006Medicaid
NJ055206Medicare ID - Type Unspecified