Healthcare Provider Details

I. General information

NPI: 1518002393
Provider Name (Legal Business Name): TARO ARAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 WEST CHESTER PIKE SUITE 201
HAVERTOWN PA
19083-3442
US

IV. Provider business mailing address

1010 WEST CHESTER PIKE SUITE 201
HAVERTOWN PA
19083-3442
US

V. Phone/Fax

Practice location:
  • Phone: 610-446-7882
  • Fax: 610-446-3316
Mailing address:
  • Phone: 610-446-7882
  • Fax: 610-446-3316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMD48802L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: