Provider Demographics
NPI:1275731689
Name:DAS, NILADRI (MD)
Entity Type:Individual
Prefix:
First Name:NILADRI
Middle Name:
Last Name:DAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NIL
Other - Middle Name:
Other - Last Name:DAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 448
Mailing Address - Street 2:
Mailing Address - City:EAST PETERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17520-0448
Mailing Address - Country:US
Mailing Address - Phone:717-391-7092
Mailing Address - Fax:717-735-2069
Practice Address - Street 1:145 N 6TH ST FL 2
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3096
Practice Address - Country:US
Practice Address - Phone:610-208-4559
Practice Address - Fax:610-404-2240
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2021-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD442875207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine