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1467765149 NPI number — PRADEEP BALASUBRAMANIAM M.D.,

NPI Number: 1467765149
Health Care Provider/Practitioner: PRADEEP BALASUBRAMANIAM M.D.,

Information about “1467765149” NPI (PRADEEP BALASUBRAMANIAM M.D.,) exists in 1467765149 in HTML format HTML  |  1467765149 in plain Text format TXT  |  1467765149 in PDF (Portable Document Format) PDF  |  1467765149 in an XML format XML  formats.

NPI Number : 1467765149 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1467765149",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BALASUBRAMANIAM",
    "FirstName": "PRADEEP",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.,",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 411011",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOSTON",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "02241-6457",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "844-362-1735",
    "MailingAddressFaxNumber": "973-290-7495",
    "FirstLinePracticeLocationAddress": "97 W PARKWAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "POMPTON PLAINS",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07444-1647",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "973-831-5140",
    "PracticeLocationAddressFaxNumber": "973-831-5318",
    "EnumerationDate": "07/22/2010",
    "LastUpdateDate": "01/16/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "275367",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "25MA10693000",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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