NPI Code Detail JSON Logo

1629369657 NPI number — ANUJ MALHOTRA MD

NPI Number: 1629369657
Health Care Provider/Practitioner: ANUJ MALHOTRA MD

Information about “1629369657” NPI (ANUJ MALHOTRA MD) exists in 1629369657 in HTML format HTML  |  1629369657 in plain Text format TXT  |  1629369657 in PDF (Portable Document Format) PDF  |  1629369657 in an XML format XML  formats.

NPI Number : 1629369657 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629369657",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MALHOTRA",
    "FirstName": "ANUJ",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "711 TROY SCHENECTADY RD",
    "SecondLineMailingAddress": "SUITE 203",
    "MailingAddressCityName": "LATHAM",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "12110-2442",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "518-782-3700",
    "MailingAddressFaxNumber": "518-782-3799",
    "FirstLinePracticeLocationAddress": "47 NEW SCOTLAND AVE",
    "SecondLinePracticeLocationAddress": "RADIOLOGY DEPT",
    "PracticeLocationAddressCityName": "ALBANY",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "12208-3412",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "518-262-5149",
    "PracticeLocationAddressFaxNumber": "518-262-4210",
    "EnumerationDate": "04/25/2011",
    "LastUpdateDate": "09/06/2022",
    "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": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2085R0204X",
          "TaxonomyName": "Vascular & Interventional Radiology Physician",
          "LicenseNumber": "278642",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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