Provider Demographics
NPI:1992894760
Name:BOKHARI, MALAK
Entity type:Individual
Prefix:DR
First Name:MALAK
Middle Name:
Last Name:BOKHARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9434
Mailing Address - Country:US
Mailing Address - Phone:412-894-8248
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY DRIVE
Practice Address - Street 2:VA PITTSBURGH HEALTH SYSTEM
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:141-268-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD061732L208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG82015Medicare UPIN
PA020960Medicare ID - Type Unspecified