Healthcare Provider Details
I. General information
NPI: 1982680146
Provider Name (Legal Business Name): NATASHA M KARANJIA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/20/2005
Last Update Date: 04/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
721 N JUNIATA ST FIRST FLOOR SUITE
HOLLIDAYSBURG PA
16648-1455
US
IV. Provider business mailing address
1414 9TH AVE STATION MEDICAL CENTER
ALTOONA PA
16602-2454
US
V. Phone/Fax
- Phone: 814-695-5591
- Fax: 814-695-7419
- Phone: 814-946-1655
- Fax: 814-949-7616
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OS009598L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: