Provider Demographics
NPI:1306867262
Name:MERRIMACK VALLEY OB/GYN INC
Entity Type:Organization
Organization Name:MERRIMACK VALLEY OB/GYN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OB/GYN
Authorized Official - Prefix:
Authorized Official - First Name:PANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-454-5150
Mailing Address - Street 1:817 MERRIMACK ST STE 11
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-3548
Mailing Address - Country:US
Mailing Address - Phone:978-454-5150
Mailing Address - Fax:978-452-7577
Practice Address - Street 1:817 MERRIMACK ST STE 11
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-3548
Practice Address - Country:US
Practice Address - Phone:978-454-5150
Practice Address - Fax:978-452-7577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA047410174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ05787OtherBCBS
MA047410OtherTUFTS
MA21985OtherFALLON
MA3013090Medicaid
MA13411OtherHARVARD PILGRIM
MA992376OtherNETWORK HEALTH
MAJ05787OtherBCBS
MA21985OtherFALLON
MA992376OtherNETWORK HEALTH