Provider Demographics
NPI:1750619854
Name:EXTON PSYCHIATRIC PRACTICE INC
Entity type:Organization
Organization Name:EXTON PSYCHIATRIC PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:URVASHI
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAGAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-594-6161
Mailing Address - Street 1:431 EXTON CMNS
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2451
Mailing Address - Country:US
Mailing Address - Phone:610-594-6161
Mailing Address - Fax:610-594-2722
Practice Address - Street 1:431 EXTON CMNS
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2451
Practice Address - Country:US
Practice Address - Phone:610-594-6161
Practice Address - Fax:610-594-2722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD049148L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABH752146Medicare PIN