Provider Demographics
NPI:1003268392
Name:PANDEY, DEEPALI (MBBS)
Entity Type:Individual
Prefix:
First Name:DEEPALI
Middle Name:
Last Name:PANDEY
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:DOLLY
Other - Middle Name:
Other - Last Name:DIDN'T HAVE LAST NAME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:800 ROSE ST # CC-402
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:650-804-3111
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST # CC-402
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:650-804-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA267816207R00000X
NY101707207RH0002X
KY53868207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine