{"npi":"1376983767","type":"NPI-1","status":"active","name":{"display":"Nitya Mambalam M.D,","other":[],"first":"NITYA","last":"MAMBALAM","middle":"BANDLA","credential":"M.D,"},"specialty":{"primary_taxonomy":"2084N0400X","primary_taxonomy_description":"Neurology","slug":"neurology","schema_org_specialty":"Neurologic","all":[{"code":"2084N0400X","description":"Neurology","primary":true,"state":"PA","license":"MD458239"}]},"addresses":[{"purpose":"LOCATION","street_1":"1417 8TH AVE","city":"BETHLEHEM","state":"PA","postal_code":"180182256","country_code":"US","phone":"4845265210","fax":"4845265237"},{"purpose":"MAILING","street_1":"1417 8TH AVE","city":"BETHLEHEM","state":"PA","postal_code":"180182256","country_code":"US","phone":"4845265210","fax":"4845265237"}],"license":{"state":"PA","number":"MD458239"},"identifiers":[{"type_code":"01","label":"Other","value":"2013021634","state":"MO","issuer":"MISSOURI TEMPORARY LICENSE"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20171019000192","type_code":"14-13","type_desc":"PRACTITIONER - NEUROLOGY","state":"PA","pac_id":"2264676931"},{"enrlmt_id":"I20180419002354","type_code":"14-13","type_desc":"PRACTITIONER - NEUROLOGY","state":"NJ","pac_id":"2264676931"}]},"enumeration_date":"2013-06-28","last_updated":"2025-10-28","_meta":{"source":"NPPES","snapshot_date":"2025-10-28","doc_url":"https://findmynpi.com/api"}}