1326018920 NPI number — PRABHA BANSAL M.D.

Table of content: PRABHA BANSAL M.D. (NPI 1326018920)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326018920 NPI number — PRABHA BANSAL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BANSAL
Provider First Name:
PRABHA
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:
1326018920
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/03/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 HOT METAL ST
Provider Second Line Business Mailing Address:
QUANTUM ONE, N431
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15203-2348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-432-5806
Provider Business Mailing Address Fax Number:
412-432-7691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1604 BURTNER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATRONA HEIGHTS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15065-2845
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-230-3030
Provider Business Practice Location Address Fax Number:
724-230-3001
Provider Enumeration Date:
01/25/2006

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: 2085R0203X , with the licence number:  MD035706L , 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: 0006584510009 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0006584510010 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0117359000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0006584510006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0006584510007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0006584510012 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0006584510013 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0006584510014 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0006584510008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0479692 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102375 . This is a "HIGHMARK BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0006584510011 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 11320212 . This is a "CAQH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0006584510005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0006584510015 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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