1942984513 NPI number — EACH1TEACH1 COMMUNITY HEALTH,LLC

Table of content: DR. REENA K. GULATI M.D. (NPI 1982852554)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942984513 NPI number — EACH1TEACH1 COMMUNITY HEALTH,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EACH1TEACH1 COMMUNITY HEALTH,LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1942984513
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3111 CLIFTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21216-2734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-271-2874
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5011 ARBUTUS AVE STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21215-5723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-271-2874
Provider Business Practice Location Address Fax Number:
410-893-7122
Provider Enumeration Date:
06/14/2023

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
WILLIE
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
443-271-2874

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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