Basic Information
Provider Information
NPI: 1679765887
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VANGURI
FirstName: SWATHI
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 196 W SPROUL RD
Address2: SUITE 208
City: SPRINGFIELD
State: PA
PostalCode: 190642045
CountryCode: US
TelephoneNumber: 3024779660
FaxNumber: 3024779495
Practice Location
Address1: 2106 SILVERSIDE RD
Address2: SUITE 202
City: WILMINGTON
State: DE
PostalCode: 198104162
CountryCode: US
TelephoneNumber: 3024779660
FaxNumber: 3024779495
Other Information
ProviderEnumerationDate: 08/11/2007
LastUpdateDate: 03/17/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XC1-0008467DEY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000XMD427983PAN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home