Provider Demographics
NPI:1326007295
Name:NIMGAONKAR, MAYA T (MD)
Entity Type:Individual
Prefix:DR
First Name:MAYA
Middle Name:T
Last Name:NIMGAONKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:
Other - Last Name:NIMGAONKAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:969 GREENTREE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3328
Mailing Address - Country:US
Mailing Address - Phone:412-920-0700
Mailing Address - Fax:412-920-0947
Practice Address - Street 1:969 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-3328
Practice Address - Country:US
Practice Address - Phone:412-920-0700
Practice Address - Fax:412-920-0947
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056130L173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001761475Medicaid
PA029311EVQMedicare ID - Type UnspecifiedINDIVIDUAL
PA001761475Medicaid
PA067022EVQMedicare ID - Type UnspecifiedGROUP
PA029311D8SMedicare PIN