Provider Demographics
NPI:1386665636
Name:DHOLAKIA, MADHURI ANIL (MD)
Entity Type:Individual
Prefix:
First Name:MADHURI
Middle Name:ANIL
Last Name:DHOLAKIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT ST STE 520
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4430
Mailing Address - Country:US
Mailing Address - Phone:800-321-9999
Mailing Address - Fax:267-339-3761
Practice Address - Street 1:2500 ENGLISH CREEK AVE STE 1300
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5598
Practice Address - Country:US
Practice Address - Phone:267-339-7843
Practice Address - Fax:267-339-3763
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428738208100000X, 2081P2900X
NJ25MA08176700208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
7353868OtherAETNA
PA2745732000OtherIBC PA
1941773OtherCIGNA
NJ2817992000OtherIBC NJ
I57819Medicare UPIN
NJP00398122Medicare PIN
NJ108214PFCMedicare PIN
NJ2817992000OtherIBC NJ
PA102897GC6Medicare PIN