Healthcare Provider Details

I. General information

NPI: 1881620516
Provider Name (Legal Business Name): PRATIBHA H PARIKH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 MCKINLEY AVE NW
CANTON OH
44703-2463
US

IV. Provider business mailing address

832 MCKINLEY AVE NW
CANTON OH
44703-2463
US

V. Phone/Fax

Practice location:
  • Phone: 330-455-9407
  • Fax: 330-455-8706
Mailing address:
  • Phone: 330-455-9407
  • Fax: 330-455-8706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35044365
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: