1477734366 NPI number — TARANGINI T. PADHYA MD, PC

Table of content: (NPI 1477734366)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477734366 NPI number — TARANGINI T. PADHYA MD, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TARANGINI T. PADHYA MD, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477734366
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
55 E 86TH AVE
Provider Second Line Business Mailing Address:
PO BOX 10645
Provider Business Mailing Address City Name:
MERRILLVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46410-6382
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-769-1670
Provider Business Mailing Address Fax Number:
219-738-6714

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
209 E 86TH CT
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
MERRILLVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46410-6259
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-736-9042
Provider Business Practice Location Address Fax Number:
219-736-9247
Provider Enumeration Date:
11/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PADHYA
Authorized Official First Name:
TARANGINI
Authorized Official Middle Name:
T.
Authorized Official Title or Position:
OWNER/PHYSICIAN
Authorized Official Telephone Number:
219-736-9042

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  01055876 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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