Provider Demographics
NPI:1154333623
Name:KAILASH MAKHIJA
Entity Type:Organization
Organization Name:KAILASH MAKHIJA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAILASH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKHIJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-377-5959
Mailing Address - Street 1:281 N 12TH ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-1101
Mailing Address - Country:US
Mailing Address - Phone:610-377-5959
Mailing Address - Fax:
Practice Address - Street 1:281 N 12TH ST
Practice Address - Street 2:SUITE F
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-1101
Practice Address - Country:US
Practice Address - Phone:610-377-5959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038068L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA084235Medicare ID - Type Unspecified