Healthcare Provider Details

I. General information

NPI: 1760464408
Provider Name (Legal Business Name): SHOBHA ASTHANA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 10/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PEASANT VILLAGE LN SUITE 101
BELLE VERNON PA
15012-4333
US

IV. Provider business mailing address

1397 CONNELLSVILLE RD
LEMONT FURNACE PA
15456-1319
US

V. Phone/Fax

Practice location:
  • Phone: 724-929-6072
  • Fax: 724-929-2812
Mailing address:
  • Phone: 724-438-7669
  • Fax: 724-434-5753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberMD044901E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: