Provider Demographics
NPI:1063441954
Name:KATARIA, VINOD KUMAR (MD)
Entity type:Individual
Prefix:MR
First Name:VINOD
Middle Name:KUMAR
Last Name:KATARIA
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 1:529 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4416
Mailing Address - Country:US
Mailing Address - Phone:610-344-7370
Mailing Address - Fax:610-344-7080
Practice Address - Street 1:529 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4416
Practice Address - Country:US
Practice Address - Phone:610-344-7370
Practice Address - Fax:610-344-7080
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037522E207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011180140003Medicaid
PA4076263OtherAETNA
PA962210OtherPA BS
PA4076263OtherAETNA
PAB42334Medicare UPIN