Healthcare Provider Details

I. General information

NPI: 1093936437
Provider Name (Legal Business Name): KAMLESH RAJ ACHARYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 01/09/2021
Certification Date: 01/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 NOLL DR
LANCASTER PA
17603-7600
US

IV. Provider business mailing address

2145 NOLL DR
LANCASTER PA
17603-7600
US

V. Phone/Fax

Practice location:
  • Phone: 717-397-4921
  • Fax: 717-397-7170
Mailing address:
  • Phone: 717-397-4921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301089172
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD346566
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: