Provider Demographics
NPI:1558905570
Name:ALLIANCE OB GYN LLC
Entity Type:Organization
Organization Name:ALLIANCE OB GYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:CHINTALAPATI
Authorized Official - Last Name:RAJU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:774-201-9962
Mailing Address - Street 1:380 MERRIMACK ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5871
Mailing Address - Country:US
Mailing Address - Phone:774-201-9962
Mailing Address - Fax:
Practice Address - Street 1:380 MERRIMACK ST STE 2A
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5871
Practice Address - Country:US
Practice Address - Phone:774-201-9962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty