1174572291 NPI number — PUNITHA ARUNKUMAR MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174572291 NPI number — PUNITHA ARUNKUMAR MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

ARUNKUMAR

Provider First Name:

PUNITHA

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

F

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:

1174572291

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/09/2016

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1803 MOUNT ROSE AVE

Provider Second Line Business Mailing Address:

SUITE B3

Provider Business Mailing Address City Name:

YORK

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

17403-3026

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

717-851-1405

Provider Business Mailing Address Fax Number:

717-851-6969

Provider First Line Business Practice Location Address:

1001 S GEORGE ST

Provider Second Line Business Practice Location Address:

MKB 4TH FLOOR

Provider Business Practice Location Address City Name:

YORK

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

17403-3676

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

717-851-2417

Provider Business Practice Location Address Fax Number:

717-851-3712

Provider Enumeration Date:

05/08/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207R00000X , with the licence number:  MD071832L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RI0200X , with the licence number: MD071832L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 7047516 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1568254 . This is a "GATEWAY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 59777 . This is a "GEISINGER HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 870493 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 909870 . This is a "CAREFIRST MD BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 212052 . This is a "JOHNS HOPKINS" identifier . This identifiers is of the category "OTHER".
• Identifier: 001812449 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 20069313 . This is a "AMERIHEALTH MERCY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 225507 . This is a "UNISON-WMG" identifier . This identifiers is of the category "OTHER".
• Identifier: 50072471 . This is a "CAPITAL BLUE CROSS-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".