Basic Information
Provider Information
NPI: 1912133471
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TALAPANENI
FirstName: BABY SIREESHA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.B.B.S
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 165 N VILLAGE AVE
Address2: SUITE 204
City: ROCKVILLE CENTRE
State: NY
PostalCode: 115703761
CountryCode: US
TelephoneNumber: 5167645380
FaxNumber: 5167641915
Practice Location
Address1: 165 N VILLAGE AVE
Address2: SUITE 204
City: ROCKVILLE CENTRE
State: NY
PostalCode: 115703761
CountryCode: US
TelephoneNumber: 5167645380
FaxNumber: 5167641915
Other Information
ProviderEnumerationDate: 06/10/2009
LastUpdateDate: 04/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X268955NYY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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