Provider Demographics
NPI:1992744767
Name:BABU, SARATH (MD)
Entity type:Individual
Prefix:
First Name:SARATH
Middle Name:
Last Name:BABU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SARATHBABU
Other - Middle Name:
Other - Last Name:YADDANAPUDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:51 W PROSPECT ST
Mailing Address - Street 2:STE 101
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5711
Mailing Address - Country:US
Mailing Address - Phone:732-249-3100
Mailing Address - Fax:732-249-7787
Practice Address - Street 1:51 W PROSPECT ST
Practice Address - Street 2:STE 101
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5711
Practice Address - Country:US
Practice Address - Phone:732-249-3100
Practice Address - Fax:732-249-7787
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06622000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7526504Medicaid
G63847Medicare UPIN
NJ005663SDTMedicare ID - Type Unspecified
NJ005663Medicare ID - Type Unspecified