Basic Information
| Provider Information | |||||||||
| NPI: | 1043524556 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEUPANEY | ||||||||
| FirstName: | ANJANA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22 PROSPECT ST | ||||||||
| Address2: | |||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030603924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038831626 | ||||||||
| FaxNumber: | 6038819914 | ||||||||
| Practice Location | |||||||||
| Address1: | 22 PROSPECT ST | ||||||||
| Address2: | |||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030603924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038831626 | ||||||||
| FaxNumber: | 6038819914 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2010 | ||||||||
| LastUpdateDate: | 03/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 4301096217 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics | 390200000X | 4301096217 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208000000X | 16423 | NH | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 3094910 | 05 | NH | MEDICAID |