Healthcare Provider Details

I. General information

NPI: 1093863631
Provider Name (Legal Business Name): NAINA VORA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OLD WEST CHESTER PIKE
HAVERTOWN PA
19083-2712
US

IV. Provider business mailing address

1143 BON AIR RD
HAVERTOWN PA
19083-3212
US

V. Phone/Fax

Practice location:
  • Phone: 484-454-8700
  • Fax: 484-454-8706
Mailing address:
  • Phone: 484-454-8700
  • Fax: 484-454-8706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD060470L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: