Provider Demographics
NPI:1740671130
Name:BAY AREA INFECTIOUS DISEASE
Entity type:Organization
Organization Name:BAY AREA INFECTIOUS DISEASE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEELAM
Authorized Official - Middle Name:TANEJA
Authorized Official - Last Name:UPPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-237-7849
Mailing Address - Street 1:369 LEXINGTON AVE
Mailing Address - Street 2:160 ST
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6506
Mailing Address - Country:US
Mailing Address - Phone:646-237-7849
Mailing Address - Fax:
Practice Address - Street 1:369 LEXINGTON AVE
Practice Address - Street 2:160 ST
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6506
Practice Address - Country:US
Practice Address - Phone:646-237-7849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-07
Last Update Date:2015-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184610261QC1500X, 261QI0500X, 261QM2500X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
F30049Medicare UPIN