Healthcare Provider Details
I. General information
NPI: 1710179643
Provider Name (Legal Business Name): JATINDER SINGH GAHLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/14/2007
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2545 SCHOENERSVILLE RD
BETHLEHEM PA
18017-7300
US
IV. Provider business mailing address
PO BOX 783311
PHILADELPHIA PA
19178-3311
US
V. Phone/Fax
- Phone: 484-884-9677
- Fax: 484-884-9297
- Phone: 484-884-4500
- Fax: 484-884-0699
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD443864 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: