=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124246574
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | B.Y.LINGANNA M.D PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2007
-----------------------------------------------------
Last Update Date | 09/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1232 S MILL ST
-----------------------------------------------------
City | NEW CASTLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16101-4812
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-654-2719
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1232 S MILL ST
-----------------------------------------------------
City | NEW CASTLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16101-4812
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-654-2719
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. BHATTARAHALLY Y LINGANNA
-----------------------------------------------------
Credential | M.D
-----------------------------------------------------
Telephone | 17246542719
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------