Healthcare Provider Details

I. General information

NPI: 1295408441
Provider Name (Legal Business Name): AVINASH VANGARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 LEONARD AVE STE 104
WASHINGTON PA
15301-3368
US

IV. Provider business mailing address

95 LEONARD AVE STE 104
WASHINGTON PA
15301-3368
US

V. Phone/Fax

Practice location:
  • Phone: 724-228-1303
  • Fax: 724-228-1513
Mailing address:
  • Phone: 724-228-1303
  • Fax: 724-228-1513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD492725
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD492725
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: