1629691050 NPI number — MEGHANA REDDY MALIPEDDI MBBS

Table of content: MEGHANA REDDY MALIPEDDI MBBS (NPI 1629691050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629691050 NPI number — MEGHANA REDDY MALIPEDDI MBBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALIPEDDI
Provider First Name:
MEGHANA
Provider Middle Name:
REDDY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MBBS
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:
1629691050
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION
Provider Second Line Business Mailing Address:
501 S WASHINGTON AVENUE
Provider Business Mailing Address City Name:
SCRANTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-343-2383
Provider Business Mailing Address Fax Number:
570-343-4800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 DOBSON WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MERRIMACK
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03054-4340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-343-2383
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2020

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: 390200000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 24090 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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