Provider Demographics
NPI:1760251078
Name:GURUNG, MADALASA
Entity Type:Individual
Prefix:
First Name:MADALASA
Middle Name:
Last Name:GURUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 COURT ST
Mailing Address - Street 2:
Mailing Address - City:ALLENSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03275-1901
Mailing Address - Country:US
Mailing Address - Phone:603-854-0891
Mailing Address - Fax:
Practice Address - Street 1:8 COURT ST
Practice Address - Street 2:
Practice Address - City:ALLENSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03275-1901
Practice Address - Country:US
Practice Address - Phone:603-854-0891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities