Provider Demographics
NPI:1972297653
Name:MAINALI, BIDUR
Entity type:Individual
Prefix:MR
First Name:BIDUR
Middle Name:
Last Name:MAINALI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SHIVASATAKSHI, DUDHE
Mailing Address - Street 2:
Mailing Address - City:JHAPA
Mailing Address - State:MECHI
Mailing Address - Zip Code:57200
Mailing Address - Country:NP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:475 SEAVIEW AVENUE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-226-8313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2024-03-11
Deactivation Date:2024-01-08
Deactivation Code:
Reactivation Date:2024-03-11
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program