Provider Demographics
NPI:1164040085
Name:BUDH, DEEPA PRAMOD
Entity Type:Individual
Prefix:DR
First Name:DEEPA
Middle Name:PRAMOD
Last Name:BUDH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 HOFFMAN ST APT 3F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-8073
Mailing Address - Country:US
Mailing Address - Phone:201-936-9752
Mailing Address - Fax:
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-1045
Practice Address - Country:US
Practice Address - Phone:570-271-9585
Practice Address - Fax:570-214-9519
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD481254208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty