Provider Demographics
NPI:1568801777
Name:VAKHARIA, RUSHABH (MD)
Entity Type:Individual
Prefix:
First Name:RUSHABH
Middle Name:
Last Name:VAKHARIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 COLGATE CT
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3390
Mailing Address - Country:US
Mailing Address - Phone:973-572-4177
Mailing Address - Fax:
Practice Address - Street 1:5728 MAJOR BLVD
Practice Address - Street 2:#528
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7945
Practice Address - Country:US
Practice Address - Phone:407-352-2542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-20
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJV02216807408862390200000X
FL128690208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program