Provider Demographics
NPI:1023210705
Name:KADIAN, RAFFI H (DPM)
Entity Type:Individual
Prefix:DR
First Name:RAFFI
Middle Name:H
Last Name:KADIAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:RTE 903 PINE POINT PLAZA SUITE 601
Mailing Address - City:ALBRIGHTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18210-0163
Mailing Address - Country:US
Mailing Address - Phone:570-722-1238
Mailing Address - Fax:215-236-8206
Practice Address - Street 1:RTE 903 PINE POINT PLAZA
Practice Address - Street 2:SUITE 601
Practice Address - City:ALBRIGHTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18210-0163
Practice Address - Country:US
Practice Address - Phone:570-722-1238
Practice Address - Fax:215-236-8206
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003243L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA13585OtherHEALTH PARTNERS
PA0011322000011Medicaid
PA1001055OtherKEYSTONE MERCY HEALTH PLA
PA0011322000011Medicaid
PA1001055OtherKEYSTONE MERCY HEALTH PLA