Basic Information
Provider Information | |||||||||
NPI: | 1366738387 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | AREPALLY | ||||||||
FirstName: | SANDEEP | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 3611 WASHINGTON ST UNIT B429 | ||||||||
Address2: |   | ||||||||
City: | BOSTON | ||||||||
State: | MA | ||||||||
PostalCode: | 021302958 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6176367689 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 800 WASHINGTON ST | ||||||||
Address2: |   | ||||||||
City: | BOSTON | ||||||||
State: | MA | ||||||||
PostalCode: | 02111 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6176367689 | ||||||||
FaxNumber: | 6176368594 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/28/2011 | ||||||||
LastUpdateDate: | 09/16/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 09/16/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 075375 | GA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207RC0200X | MD16342 | RI | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RS0012X | 075375 | GA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RS0012X | MD16342 | RI | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RP1001X | MD16342 | RI | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.