Provider Demographics
NPI: | 1982699823 |
---|---|
Name: | NARAYAN, PRITHVI (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | PRITHVI |
Middle Name: | |
Last Name: | NARAYAN |
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: | 3601 A ST |
Mailing Address - Street 2: | |
Mailing Address - City: | PHILADELPHIA |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 19134-1043 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 215-427-5196 |
Mailing Address - Fax: | 215-427-4638 |
Practice Address - Street 1: | 3601 A ST |
Practice Address - Street 2: | |
Practice Address - City: | PHILADELPHIA |
Practice Address - State: | PA |
Practice Address - Zip Code: | 19134-1043 |
Practice Address - Country: | US |
Practice Address - Phone: | 215-427-5196 |
Practice Address - Fax: | 215-427-4638 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-09-16 |
Last Update Date: | 2010-09-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | MD431277 | 207T00000X |
NJ | 25MA08005300 | 207T00000X |
NY | 231546-1 | 174400000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | |
No | 174400000X | Other Service Providers | Specialist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NJ | 114033VE7 | Medicare PIN | |
I09184 | Medicare UPIN | ||
PA | 113458T2L | Medicare PIN | |
NY | I09184 | Medicare UPIN |