Provider Demographics
NPI:1740314053
Name:PALANISWAMY, GUHAPRIYA (MD)
Entity type:Individual
Prefix:DR
First Name:GUHAPRIYA
Middle Name:
Last Name:PALANISWAMY
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 1:442 E LONG AVE
Mailing Address - Street 2:PULMONARY CLINIC OF THE CAROLINAS
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2527
Mailing Address - Country:US
Mailing Address - Phone:704-867-8742
Mailing Address - Fax:
Practice Address - Street 1:442 E LONG AVE
Practice Address - Street 2:PULMONARY CLINIC OF THE CAROLINAS
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2527
Practice Address - Country:US
Practice Address - Phone:704-867-8742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08045300207R00000X, 207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0205478Medicaid
NJ0205478Medicaid