Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 283 | MA |
N | 207Q00000X | Family Doctor | BP1-0032426 | TX |
N | 207VX0000X | Obstetrician | R2843 | TN |
NPI | 1306009717 |
---|---|
Provider Name | Dr. Sanjeevani Vijaykumar Deolapure |
First Address | Leominster, MA 01453-5507 |
Second Address | Leominster, MA 01453-5507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 02/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3742587-01 | (05) | TX |