1568666303 NPI number — DR. ZUBIN PAULSON KOLANGADEN MD

Table of content: DR. ZUBIN PAULSON KOLANGADEN MD (NPI 1568666303)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568666303 NPI number — DR. ZUBIN PAULSON KOLANGADEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOLANGADEN
Provider First Name:
ZUBIN
Provider Middle Name:
PAULSON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1568666303
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2149 E WARNER RD
Provider Second Line Business Mailing Address:
STE 102
Provider Business Mailing Address City Name:
TEMPE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85284-3495
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-610-6134
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 TOWN CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 152
Provider Business Practice Location Address City Name:
LANGHORNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19047-1753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-741-3510
Provider Business Practice Location Address Fax Number:
215-741-3517
Provider Enumeration Date:
06/14/2007

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: 207RN0300X , with the licence number:  MD453108 , 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: MD453108 . This is a "PA MEDICAL LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com