Provider Demographics
NPI:1326343732
Name:RAJPATHAK, RUPALI (MD, SM)
Entity Type:Individual
Prefix:DR
First Name:RUPALI
Middle Name:
Last Name:RAJPATHAK
Suffix:
Gender:F
Credentials:MD, SM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 MARYLAND RD
Mailing Address - Street 2:SUITE #400
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1216
Mailing Address - Country:US
Mailing Address - Phone:215-481-3064
Mailing Address - Fax:
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:DIXON BLDG, SUITE #201
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-6839
Practice Address - Fax:215-481-3515
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443208207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102655934Medicaid
PA102655934Medicaid