=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134987704
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR FAMILY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2024
-----------------------------------------------------
Last Update Date | 03/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 502 W 7TH ST STE 100
-----------------------------------------------------
City | ERIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16502-1333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-258-4243
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 502 W 7TH ST STE 100
-----------------------------------------------------
City | ERIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16502-1333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-258-4243
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | KARANVIR SINGH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 347-755-8521
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------