Provider Demographics
NPI:1700044682
Name:VANGEEPURAM, NITA (MD)
Entity Type:Individual
Prefix:
First Name:NITA
Middle Name:
Last Name:VANGEEPURAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PLACE BOX 1512
Mailing Address - Street 2:MOUNT SINAI MEDICAL CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE L LEVY PLACE
Practice Address - Street 2:MOUNT SINAI MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-9274
Practice Address - Fax:212-241-4309
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2013-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY227151208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics