Healthcare Provider Details

I. General information

NPI: 1770015174
Provider Name (Legal Business Name): RAVI PAREKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 W EUGIE AVE STE 213
GLENDALE AZ
85304-1258
US

IV. Provider business mailing address

1200 OLD YORK RD STE 106
ABINGTON PA
19001-3720
US

V. Phone/Fax

Practice location:
  • Phone: 602-865-5618
  • Fax:
Mailing address:
  • Phone: 215-481-2233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number75796
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: