Healthcare Provider Details

I. General information

NPI: 1538354022
Provider Name (Legal Business Name): KALWANI & KHADILKAR, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2007
Last Update Date: 10/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7924 BUSTLETON AVE
PHILA PA
19152-3321
US

IV. Provider business mailing address

7924 BUSTLETON AVE
PHILADELPHIA PA
19152-3321
US

V. Phone/Fax

Practice location:
  • Phone: 215-725-3900
  • Fax: 215-725-3273
Mailing address:
  • Phone: 215-725-3900
  • Fax: 215-725-3273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD037624L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD037280L
License Number StatePA

VIII. Authorized Official

Name: HEMLATA KALWANI
Title or Position: OWNER
Credential: MD
Phone: 215-725-3900