Healthcare Provider Details

I. General information

NPI: 1427617372
Provider Name (Legal Business Name): PATRICIA IROABUCHI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3193 CAPE HORN RD
RED LION PA
17356-8810
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-812-5888
  • Fax: 717-741-3709
Mailing address:
  • Phone: 717-812-5888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT019270
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS022129
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: