Basic Information
| Provider Information | |||||||||
| NPI: | 1831462241 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PAUDEL | ||||||||
| FirstName: | SITA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 858 | ||||||||
| Address2: | MC A410 | ||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170330858 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431445 | ||||||||
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| Practice Location | |||||||||
| Address1: | 500 UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170332360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175318790 | ||||||||
| FaxNumber: | 7175310245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2012 | ||||||||
| LastUpdateDate: | 10/16/2019 | ||||||||
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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 | 2080P0008X | MD468617 | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neurodevelopmental Disabilities | 208000000X | 9387 | SD | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 3619F | AL | N | Allopathic & Osteopathic Physicians | Pediatrics | 2084N0402X | MD468617 | PA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology | 390200000X | 0100 | NY | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
ID Information
| ID | Type | State | Issuer | Description | 1036682760001 | 05 | PA | MEDICAID | 138438 | 05 | AL | MEDICAID | 138886 | 05 | AL | MEDICAID |