Provider Demographics
NPI:1518209139
Name:REGIONAL RHEUMATOLOGY, PC
Entity Type:Organization
Organization Name:REGIONAL RHEUMATOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MANISHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:NAIK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:267-685-0785
Mailing Address - Street 1:1205 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:ST MARY MEDICAL BUILDING, SUITE 406B
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1219
Mailing Address - Country:US
Mailing Address - Phone:267-685-0785
Mailing Address - Fax:
Practice Address - Street 1:1205 LANGHORNE NEWTOWN RD
Practice Address - Street 2:ST. MARY MEDICAL BLDG, SUITE 406B
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1219
Practice Address - Country:US
Practice Address - Phone:267-685-0785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-21
Last Update Date:2013-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013402207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty