1801195094 NPI number — PREETHI CHINTAMANENI M.D.

Table of content: PREETHI CHINTAMANENI M.D. (NPI 1801195094)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801195094 NPI number — PREETHI CHINTAMANENI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHINTAMANENI
Provider First Name:
PREETHI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1801195094
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1307 FEDERAL ST STE B100
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:
15212-4761
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-359-8900
Provider Business Mailing Address Fax Number:
412-359-8977

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1307 FEDERAL ST STE B100
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:
15212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-359-8900
Provider Business Practice Location Address Fax Number:
412-359-8977
Provider Enumeration Date:
03/28/2011

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: 207R00000X , with the licence number:  MD451180 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X , with the licence number: MD451180 , 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: 13760948 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 102956437 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".