Healthcare Provider Details

I. General information

NPI: 1124552435
Provider Name (Legal Business Name): IAN GARRAHY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 09/13/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 MIDDLETOWN BLVD STE 205
LANGHORNE PA
19047-1832
US

IV. Provider business mailing address

240 MIDDLETOWN BLVD STE 205
LANGHORNE PA
19047-1832
US

V. Phone/Fax

Practice location:
  • Phone: 215-750-1927
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOT017577
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberOS022886
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: