Basic Information
Provider Information
NPI: 1427614619
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROY
FirstName: BINDHU
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ACNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PAUL
OtherFirstName: BINDHU
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 7033 EDGARTOWN ST
Address2:  
City: ROSEVILLE
State: CA
PostalCode: 957474227
CountryCode: US
TelephoneNumber: 7132137588
FaxNumber:  
Practice Location
Address1: 1485 RIVER PARK DR STE 200
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958154530
CountryCode: US
TelephoneNumber: 9163251040
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/14/2019
LastUpdateDate: 05/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X95011343CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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