Provider Demographics
NPI:1427084672
Name:RIFAI, AICHA H (MD)
Entity type:Individual
Prefix:
First Name:AICHA
Middle Name:H
Last Name:RIFAI
Suffix:
Gender:F
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:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19603-0316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:640 WALNUT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3504
Practice Address - Country:US
Practice Address - Phone:610-378-2032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041747D2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
407942FE7Medicare PIN
PAD68840Medicare UPIN