Provider Demographics
NPI:1689092439
Name:ABHYANKAR, LALITA (MD MHS)
Entity Type:Individual
Prefix:
First Name:LALITA
Middle Name:
Last Name:ABHYANKAR
Suffix:
Gender:F
Credentials:MD MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 CORTE MADERA TOWN CTR
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1207
Mailing Address - Country:US
Mailing Address - Phone:415-840-8615
Mailing Address - Fax:
Practice Address - Street 1:303 CORTE MADERA TOWN CTR
Practice Address - Street 2:
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1207
Practice Address - Country:US
Practice Address - Phone:415-840-8615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-30
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY290416207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine