Provider Demographics
NPI:1841226164
Name:NAGPAL, VANDANA (MD)
Entity Type:Individual
Prefix:
First Name:VANDANA
Middle Name:
Last Name:NAGPAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:119 BELMONT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2903
Practice Address - Country:US
Practice Address - Phone:508-334-8630
Practice Address - Fax:508-334-8271
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD441433207R00000X
ND9646207R00000X
MA257066207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND150108900Medicaid
ND24930OtherNDBS #
ND0407068OtherINN MEDICA #
NDHP47428OtherHEALTHPARTNERS #
ND137090OtherUCARE #
NDDA9011042450OtherPREF 1 #
ND0407067OtherFGO MEDICA #
ND13235Medicaid
ND36731OtherLHS #
ND892S0NAOtherMNBS #
ND2205949OtherARAZ #
ND0407067OtherFGO MEDICA #
ND137090OtherUCARE #
ND2205949OtherARAZ #