Provider Demographics
NPI:1073840005
Name:TRIANGLE WOMEN'S CENTER PC
Entity Type:Organization
Organization Name:TRIANGLE WOMEN'S CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NADENDLA
Authorized Official - Suffix:
Authorized Official - Credentials:MDFACOG
Authorized Official - Phone:919-725-3176
Mailing Address - Street 1:115 PARKWAY OFFICE CT
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7430
Mailing Address - Country:US
Mailing Address - Phone:919-342-5383
Mailing Address - Fax:919-342-0434
Practice Address - Street 1:115 PARKWAY OFFICE CT
Practice Address - Street 2:SUITE 104
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7430
Practice Address - Country:US
Practice Address - Phone:919-342-5383
Practice Address - Fax:919-342-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01841207V00000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910738Medicaid