Healthcare Provider Details

I. General information

NPI: 1295552388
Provider Name (Legal Business Name): ANURADHA BISHNOI MBBS, MD, DNB, FRCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 01/19/2025
Certification Date: 01/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 BROOKTREE RD STE 200
WEXFORD PA
15090-9288
US

IV. Provider business mailing address

9000 BROOKTREE RD STE 200
WEXFORD PA
15090-9288
US

V. Phone/Fax

Practice location:
  • Phone: 947-205-8195
  • Fax:
Mailing address:
  • Phone: 724-933-1320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberLT001042
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License NumberLT001042
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberLT001042
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: