Organization
NORTHEAST PEDIATRICS LLC
Active
Other names
Dr.L.Narayana Gajula & associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. L.NARAYANA GAJULA M.D. (OWNER)
(610) 377-6969
Entity
Organization
Contact information
Practice address
281 N 12TH ST, SUITE E, LEHIGHTON, PA 18235-1101
(610) 377-6969
Mailing address
281 N 12TH ST, SUITE E, LEHIGHTON, PA 18235-1101
(610) 377-6969
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD022461E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00571402
MEDICAID
PA
Enumeration date
07/10/2007
Last updated
07/10/2007
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