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General NPI Number Information
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NPI Number | 1174624530
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Entity Type | Organization
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Legal Business Name | PRADEEP S. GHIA, M.D., P.C.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 123 S 22ND ST
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City | EASTON
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State | PA
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Zip | 18042-3808
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Country | US
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Telephone | 610-258-6211
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Fax | 610-258-9995
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Provider Business Mailing Address
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Address Line | 123 S 22ND ST
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City | EASTON
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State | PA
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Zip | 18042-3808
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Country | US
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Telephone | 610-258-6211
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Fax | 610-258-9995
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | PRADEEP S GHIA
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Credential | M.D.
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Telephone | 610-258-6211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD-037787-L
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License Number State | PA
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