1730490749 NPI number — DR. VANI MURTHY HALAHALLI SRINIVASA MS

Table of content: STEPHEN F AHRENS PT (NPI 1003224502)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730490749 NPI number — DR. VANI MURTHY HALAHALLI SRINIVASA MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HALAHALLI SRINIVASA
Provider First Name:
VANI
Provider Middle Name:
MURTHY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MS
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:
1730490749
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16, INDUSTRIAL SUBURB
Provider Second Line Business Mailing Address:
VISHVESHWARA NAGAR, SECOND STAGE
Provider Business Mailing Address City Name:
MYSORE
Provider Business Mailing Address State Name:
KARNATAKA
Provider Business Mailing Address Postal Code:
570008
Provider Business Mailing Address Country Code:
IN
Provider Business Mailing Address Telephone Number:
984-574-0765
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23RD STREET FIRST AVENUE
Provider Second Line Business Practice Location Address:
423 VA HOSPITAL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-285-6245
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/24/2010

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: 1744R1102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1744R1103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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