Provider Demographics
NPI:1881992196
Name:RAUT, AVINASH UDARAM (MS)
Entity type:Individual
Prefix:
First Name:AVINASH
Middle Name:UDARAM
Last Name:RAUT
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WELLINGTON RD APT 1
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-2443
Mailing Address - Country:US
Mailing Address - Phone:267-328-8215
Mailing Address - Fax:
Practice Address - Street 1:9 WELLINGTON RD APT 1
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2443
Practice Address - Country:US
Practice Address - Phone:267-328-8215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health