Provider Demographics
NPI:1750534343
Name:NERURKAR, ANIL (MD)
Entity type:Individual
Prefix:DR
First Name:ANIL
Middle Name:
Last Name:NERURKAR
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 1:1203 LANGHORNE-NEWTOWN RD
Mailing Address - Street 2:#225, ST CLARE BLDG
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-750-7771
Mailing Address - Fax:215-750-6935
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD
Practice Address - Street 2:#225, ST CLARE BLDG
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1209
Practice Address - Country:US
Practice Address - Phone:215-750-7771
Practice Address - Fax:215-750-6935
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037711-L207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008147700002Medicaid
PAC28530Medicare UPIN
PA465928Medicare PIN