Provider Demographics
NPI:1497874440
Name:VORA, VAISHALI S (DO)
Entity Type:Individual
Prefix:DR
First Name:VAISHALI
Middle Name:S
Last Name:VORA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 RACE ST FL 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1125
Mailing Address - Country:US
Mailing Address - Phone:215-587-3406
Mailing Address - Fax:215-557-8256
Practice Address - Street 1:1513 RACE ST FL 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1125
Practice Address - Country:US
Practice Address - Phone:215-587-3406
Practice Address - Fax:215-557-8256
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014018208100000X
DEC2-0024340208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102759302Medicaid
PA102759302Medicaid