MEDICARE: MRS. ANITA ROHATGI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD 039725L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	421460	OTHER	PA	B. SHIELD
2	50009845	OTHER	PA	CAPITOL BC

General Provider Information

NPI Number	:	1639178411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANITA ROHATGI MD

Provider Business Mailing Address
First Line	:	101 S SCHANCK AVE
Second Line	:
City	:	PEN ARGYL
State	:	PA
Zip	:	18072-1697
Country	:	US
Telephone Number	:	610-863-9059
Fax Number	:	610-863-1995

Provider Business Practice Location Address
First Line	:	101 S SCHANCK AVE
Second Line	:
City	:	PEN ARGYL
State	:	PA
Zip	:	18072-1697
Country	:	US
Telephone Number	:	610-863-9059
Fax Number	:	610-863-1995

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/08/2007

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