1821666173 NPI number — MALLORY LYNN ADHIKARI CRNA

Table of content: MALLORY LYNN ADHIKARI CRNA (NPI 1821666173)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821666173 NPI number — MALLORY LYNN ADHIKARI CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADHIKARI
Provider First Name:
MALLORY
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAYES
Provider Other First Name:
MALLORY
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1821666173
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4031 CIRCLE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAKERSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15007-1001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-217-2017
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 E NORTH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15212-4756
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-217-2017
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2021

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: 367500000X , with the licence number:  241075 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: RN650340 , 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)