Provider Demographics
NPI:1700881810
Name:GERIATRIC & ADULT MEDICINE, PC
Entity type:Organization
Organization Name:GERIATRIC & ADULT MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAWAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-741-5959
Mailing Address - Street 1:1501 MOUNT ROSE AVE STE 6B
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2989
Mailing Address - Country:US
Mailing Address - Phone:717-741-5959
Mailing Address - Fax:717-741-4395
Practice Address - Street 1:1501 MOUNT ROSE AVE STE 6B
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2989
Practice Address - Country:US
Practice Address - Phone:717-741-5959
Practice Address - Fax:717-741-4395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066389L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA022295TD1Medicare PIN
PA084932Medicare PIN
PAP00167400Medicare PIN
PAG35722Medicare UPIN
PADN6874Medicare PIN