1942220165 NPI number — WANDANA JOSHI D.O.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942220165 NPI number — WANDANA JOSHI D.O.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

JOSHI

Provider First Name:

WANDANA

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

D.O.

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:

1942220165

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/05/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1 MEDICAL CENTER DR

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

LEBANON

Provider Business Mailing Address State Name:

NH

Provider Business Mailing Address Postal Code:

03756-1000

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

1 MEDICAL CENTER DR

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

LEBANON

Provider Business Practice Location Address State Name:

NH

Provider Business Practice Location Address Postal Code:

03756

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

603-650-5922

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

07/20/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207L00000X , with the licence number:  60290 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207L00000X , with the licence number: 18428 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 13433 . This is a "HNE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: HX4516 . This is a "MEDICARE ID-TYPE UNSPECIFIED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 060290 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 2598526 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 3068897 . This is a "DPW" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: JOJ10559 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 000000006514 . This is a "HEALTHNET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 275136 . This is a "HARVARD PILGRIM HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 043500 . This is a "CONNECTICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".