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PREETHI IDICULLA NP
NPI 1164957494
Nurse Practitioner - Family in Union, NJ

Active since April 24, 2017

NPPES record last updated: September 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 3, 2024, Aug 25, 2023, Apr 24, 2017 (3 updates tracked since 2017).

About Preethi Idiculla Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREETHI IDICULLA NP (NPI 1164957494) is an individual family provider in Union, New Jersey, licensed in New Jersey (26NJ01318900) and active in the NPI registry since April 2017.

NPPES Registry Identity

NPI1164957494
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NamePREETHI IDICULLACredential: NP
Location Address968 WENDY CTUnion, NJ 07083-5637
Mailing Address968 Wendy CtUnion, NJ 07083-5637 · (917) 858-0953
Phone(917) 858-0953
Sole ProprietorYes
Enumeration DateApril 24, 2017
Last NPPES UpdateSeptember 3, 20243 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2024
✔ NPI 1164957494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NJ · 26NJ01318900
Also ListedRegistered Nurse · Registered Nurse First AssistantTaxonomy 163WR0006X · License 26NR1204800 (NJ)
968 WENDY CT, Union, NJ 07083
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Preethi Idiculla's NPI number?

The NPI number for Preethi Idiculla is 1164957494. It was assigned to this individual provider in the NPPES registry on April 24, 2017.

Where is Preethi Idiculla located?

Preethi Idiculla practices at 968 Wendy Ct, Union, NJ 07083. The listed phone number is (917) 858-0953.

What is Preethi Idiculla's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Preethi Idiculla was last updated on September 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.