Basic Information
Provider Information
NPI: 1962765230
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PENDURTHI
FirstName: APARNA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3901 RAINBOW BLVD
Address2: MAILSTOP 2012
City: KANSAS CITY
State: KS
PostalCode: 66160
CountryCode: US
TelephoneNumber: 9135885000
FaxNumber:  
Practice Location
Address1: 3901 RAINBOW BLVD
Address2: MAILSTOP 2012
City: KANSAS CITY
State: KS
PostalCode: 66160
CountryCode: US
TelephoneNumber: 9135885000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/20/2012
LastUpdateDate: 01/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084V0102X04-39928KSY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology

No ID Information.


Home