Provider Demographics
NPI:1710145404
Name:DHARIA, PRACHI S (MD)
Entity Type:Individual
Prefix:DR
First Name:PRACHI
Middle Name:S
Last Name:DHARIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PRACHI
Other - Middle Name:SUNIL
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 STRATFORD N
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2316
Mailing Address - Country:US
Mailing Address - Phone:516-625-2943
Mailing Address - Fax:
Practice Address - Street 1:118 STRATFORD N
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2316
Practice Address - Country:US
Practice Address - Phone:516-625-2943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248048207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine