1225254741 NPI number — LAVANYA KARRI MD

Table of content: LAVANYA KARRI MD (NPI 1225254741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225254741 NPI number — LAVANYA KARRI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KARRI
Provider First Name:
LAVANYA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1225254741
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/01/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 S JACKSON AVE FL 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15202-3428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-359-8951
Provider Business Mailing Address Fax Number:
412-734-7795

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 S JACKSON AVE FL 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15202-3428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-359-8951
Provider Business Practice Location Address Fax Number:
412-734-7795
Provider Enumeration Date:
04/17/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD438485 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 12009437 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 102387092 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".