Provider Demographics
NPI:1457759599
Name:DHOLAKIA, KRIPA
Entity Type:Individual
Prefix:
First Name:KRIPA
Middle Name:
Last Name:DHOLAKIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S 48H STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-3587
Mailing Address - Country:US
Mailing Address - Phone:267-439-7629
Mailing Address - Fax:
Practice Address - Street 1:900 S 48H STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-3587
Practice Address - Country:US
Practice Address - Phone:267-439-7629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012854L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist