Provider Demographics
NPI:1578507893
Name:YANAMADULA, DINASH KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:DINASH
Middle Name:KUMAR
Last Name:YANAMADULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DINASH
Other - Middle Name:KUMAR
Other - Last Name:YANAMADULA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:90 MATAWAN RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2653
Mailing Address - Country:US
Mailing Address - Phone:732-441-7177
Mailing Address - Fax:732-441-7165
Practice Address - Street 1:123 FRANKLIN CORNER RD STE 114
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2526
Practice Address - Country:US
Practice Address - Phone:609-512-1690
Practice Address - Fax:609-512-1674
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07339500208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H86402Medicare UPIN
57645Medicare ID - Type Unspecified