Basic Information
Provider Information
NPI: 1114098852
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VEERAMALLA
FirstName: CHARANJIT
MiddleName: REDDY
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 59 PAGE HILL RD
Address2:  
City: BERLIN
State: NH
PostalCode: 035703531
CountryCode: US
TelephoneNumber: 6037522200
FaxNumber:  
Practice Location
Address1: 59 PAGE HILL RD
Address2:  
City: BERLIN
State: NH
PostalCode: 035703531
CountryCode: US
TelephoneNumber: 6037522200
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/13/2006
LastUpdateDate: 02/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X14274NHN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X25MA08121900NJN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XE-5971ARY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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