Provider Demographics
NPI:1902917347
Name:GHOSHHAJRA, K (MD)
Entity type:Individual
Prefix:DR
First Name:K
Middle Name:
Last Name:GHOSHHAJRA
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 1:401 LIBERTY AVE # 7E
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-1000
Mailing Address - Country:US
Mailing Address - Phone:412-223-2272
Mailing Address - Fax:412-281-6320
Practice Address - Street 1:401 LIBERTY AVE # 7E
Practice Address - Street 2:SUITE 2000
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-1000
Practice Address - Country:US
Practice Address - Phone:412-223-2272
Practice Address - Fax:412-281-6320
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031601L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007976510001Medicaid
PA0007976510001Medicaid
PA038361Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER #