1205818010 NPI number — USHA TRIPATHI MD

Table of content: USHA TRIPATHI MD (NPI 1205818010)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205818010 NPI number — USHA TRIPATHI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRIPATHI
Provider First Name:
USHA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205818010
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
73 PRINCETON ST
Provider Second Line Business Mailing Address:
SUITE 203
Provider Business Mailing Address City Name:
NORTH CHELMSFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01863-1558
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-256-6579
Provider Business Mailing Address Fax Number:
978-256-1943

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
73 PRINCETON ST
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
NORTH CHELMSFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01863-1558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-256-6579
Provider Business Practice Location Address Fax Number:
978-256-1943
Provider Enumeration Date:
11/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  51027 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 260051459 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J25713 . This is a "BCBSMA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0022320 . This is a "NHP" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 01Y001496MA01 . This is a "BCBSNH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 333109 . This is a "MHN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2037335 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 043476807-04 . This is a "PACIFICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 493219000 . This is a "MAGELLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 971704 . This is a "NETWORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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