Provider Demographics
NPI:1992720866
Name:VENKAT, ANU (MD)
Entity type:Individual
Prefix:
First Name:ANU
Middle Name:
Last Name:VENKAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANURADHA
Other - Middle Name:
Other - Last Name:VENKATASUBRAMAMIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:254 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1766
Mailing Address - Country:US
Mailing Address - Phone:732-339-7870
Mailing Address - Fax:732-214-9186
Practice Address - Street 1:254 EASTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1766
Practice Address - Country:US
Practice Address - Phone:732-339-7870
Practice Address - Fax:732-214-9186
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426837208000000X, 2084N0400X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology