Provider Demographics
NPI:1922158542
Name:OBEROI, MANDEEP S (MD)
Entity Type:Individual
Prefix:
First Name:MANDEEP
Middle Name:S
Last Name:OBEROI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:1800 E PARK AVE.
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-5602
Practice Address - Country:US
Practice Address - Phone:814-231-7000
Practice Address - Fax:814-231-7022
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT62385207P00000X
NJMA66667207R00000X
PAMD450634207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029169230001Medicaid
NJ7436408Medicaid
NJG60239Medicare UPIN
PA1029169230001Medicaid