Provider Demographics
NPI:1619922101
Name:VORA, KAPILA SURESH (MD)
Entity Type:Individual
Prefix:
First Name:KAPILA
Middle Name:SURESH
Last Name:VORA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAPILA
Other - Middle Name:HIRALAL
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:1936 WOODED RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FOGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18051-1735
Mailing Address - Country:US
Mailing Address - Phone:610-285-2513
Mailing Address - Fax:610-285-2513
Practice Address - Street 1:1936 WOODED RIDGE CT
Practice Address - Street 2:
Practice Address - City:FOGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18051-1735
Practice Address - Country:US
Practice Address - Phone:610-285-2513
Practice Address - Fax:610-285-2513
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036770L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB89009Medicare UPIN
PA711675Medicare ID - Type Unspecified