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Contact Information

VIDYA M MEDEPALLI, MD
20 PROSPECT AVE STE 702
HACKENSACK, NJ07601-1974
 Phone: 908-359-8980
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Procedural Dermatology

207NS0135X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for VIDYA M MEDEPALLI · (Female)

NPI # 1043890775
Status Active
Credentials MD
Entity Individual
Enumeration date 04/08/2021
Last updated 07/04/2025 - About 11 months ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # 25MA12744700
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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