Healthcare Provider Details

I. General information

NPI: 1346499431
Provider Name (Legal Business Name): NITIN OHRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 CHESTNUT ST APT 1011
PHILADELPHIA PA
19107-5127
US

IV. Provider business mailing address

834 CHESTNUT ST APT 1011
PHILADELPHIA PA
19107-5127
US

V. Phone/Fax

Practice location:
  • Phone: 516-672-2711
  • Fax:
Mailing address:
  • Phone: 516-672-2711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License NumberMT193916
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: