Healthcare Provider Details

I. General information

NPI: 1790425155
Provider Name (Legal Business Name): ARJUN HASIT PANDYA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SCENERY DR
STATE COLLEGE PA
16801-7974
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 814-231-4560
  • Fax: 814-231-6246
Mailing address:
  • Phone: 814-231-4560
  • Fax: 814-231-6246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD495504
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: