Healthcare Provider Details

I. General information

NPI: 1912992967
Provider Name (Legal Business Name): SAEED TAROKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 W OAK ST
TITUSVILLE PA
16354-1416
US

IV. Provider business mailing address

512 E SPRUCE ST
TITUSVILLE PA
16354-2049
US

V. Phone/Fax

Practice location:
  • Phone: 814-827-3814
  • Fax: 814-827-6312
Mailing address:
  • Phone: 814-827-7170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD428233
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number244670
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: