Provider Demographics
NPI:1508484163
Name:BORICHA, HETAL RAMESH (MD)
Entity Type:Individual
Prefix:
First Name:HETAL
Middle Name:RAMESH
Last Name:BORICHA
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 1:3600 FORBES AVENUE
Mailing Address - Street 2:FORBES TOWER - PLAZA LEVEL SUITE 140
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:412-919-7919
Mailing Address - Fax:
Practice Address - Street 1:1321 FIFTH AVENUE SUITE 1, MCKEESPORT INTERNAL MEDICINE
Practice Address - Street 2:SUITE 1
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132
Practice Address - Country:US
Practice Address - Phone:412-664-2782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2023-04-20
Deactivation Date:2022-01-19
Deactivation Code:
Reactivation Date:2023-04-12
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
PAMT220918390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program