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General NPI Number Information
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NPI Number | 1760624373
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Entity Type | Individual
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Provider Name | ABHILASHA TANGADA MD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 119 BELMONT ST
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City | WORCESTER
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State | MA
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Zip | 01605
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Country | US
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Telephone | 508-334-6388
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Fax |
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Provider Business Mailing Address
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Address Line | 611 W PARK ST
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City | URBANA
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State | IL
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Zip | 61801-2501
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Country | US
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Telephone | 217-383-3311
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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 | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 0361628
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License Number State | IL
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