MEDICARE: POULOMEE TRIPATHI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1255071049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POULOMEE TRIPATHI

Provider Business Mailing Address
First Line	:	2195 HARRODSBURG RD STE 125
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3543
Country	:	US
Telephone Number	:	859-257-4732
Fax Number	:	859-323-6661

Provider Business Practice Location Address
First Line	:	450 BROADWAY ST FL 2
Second Line	:
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-3132
Country	:	US
Telephone Number	:	650-723-6601
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	03/22/2026

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Directions to “ POULOMEE TRIPATHI ” Practice Location

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