Provider Demographics
NPI:1295716157
Name:VINNAKOTA, RAO V (MD,)
Entity type:Individual
Prefix:DR
First Name:RAO
Middle Name:V
Last Name:VINNAKOTA
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
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Mailing Address - Street 1:6 RAVINN LN
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5572
Mailing Address - Country:US
Mailing Address - Phone:908-753-2662
Mailing Address - Fax:908-753-2633
Practice Address - Street 1:2013 PARK AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5401
Practice Address - Country:US
Practice Address - Phone:908-753-2662
Practice Address - Fax:908-753-2633
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02514200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics