Healthcare Provider Details

I. General information

NPI: 1861692113
Provider Name (Legal Business Name): VAZE INC., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 WELSH RD STE 101
HUNTINGDON VALLEY PA
19006-6357
US

IV. Provider business mailing address

727 WELSH RD STE 101
HUNTINGDON VALLEY PA
19006-6357
US

V. Phone/Fax

Practice location:
  • Phone: 215-914-0600
  • Fax: 215-914-0115
Mailing address:
  • Phone: 215-914-0600
  • Fax: 215-914-0115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD051961L
License Number StatePA

VIII. Authorized Official

Name: MILIND M VAZE
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 215-914-0600