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General NPI Number Information
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NPI Number | 1104566108
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Entity Type | Individual
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Provider Name | DIVYA MENGHANI M.B.B.S.
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Gender | Female
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 740 S LIMESTONE ROOM J401
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-218-5038
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Fax | 859-257-0754
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Provider Business Mailing Address
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Address Line | 5140 S HYDE PARK BLVD APT 15E
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City | CHICAGO
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State | IL
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Zip | 60615-4265
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Country | US
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Telephone | 317-798-7917
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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