Basic Information
Provider Information | |||||||||
NPI: | 1922248400 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | NARINEDHAT | ||||||||
FirstName: | RALPH | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1155 MILL ST # MCM14 | ||||||||
Address2: |   | ||||||||
City: | RENO | ||||||||
State: | NV | ||||||||
PostalCode: | 895021576 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7759825262 | ||||||||
FaxNumber: | 7759825496 | ||||||||
Practice Location | |||||||||
Address1: | 903 MEDICAL CENTER DR | ||||||||
Address2: |   | ||||||||
City: | ARLINGTON | ||||||||
State: | WA | ||||||||
PostalCode: | 982231697 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3604350242 | ||||||||
FaxNumber: | 3604359135 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 02/24/2009 | ||||||||
LastUpdateDate: | 02/03/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 02/03/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 25MA08498700 | NJ | N |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   | 207V00000X | ME103614 | FL | N |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   | 207V00000X | 036137155 | IL | N |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   | 207V00000X | MD61258157 | WA | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   | 207V00000X | 13150 | NV | N |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   |
ID Information
ID | Type | State | Issuer | Description | 036137155 | 05 | IL |   | MEDICAID | 1922248400 | 05 | NV |   | MEDICAID | 11974240 | 01 |   | CAQH | OTHER |