Provider Demographics
NPI:1407825417
Name:VAKHARIA, PRATIBHA V (MD)
Entity Type:Individual
Prefix:DR
First Name:PRATIBHA
Middle Name:V
Last Name:VAKHARIA
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:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:BURNHAM
Mailing Address - State:PA
Mailing Address - Zip Code:17009-0099
Mailing Address - Country:US
Mailing Address - Phone:717-248-9550
Mailing Address - Fax:717-248-9558
Practice Address - Street 1:418 N LOGAN BLVD
Practice Address - Street 2:
Practice Address - City:BURNHAM
Practice Address - State:PA
Practice Address - Zip Code:17009-1816
Practice Address - Country:US
Practice Address - Phone:717-248-9550
Practice Address - Fax:717-248-9558
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040650E174400000X
PAMD-040650-E207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No174400000XOther Service ProvidersSpecialist