=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609152248
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SMITA GAIKWAD M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2011
-----------------------------------------------------
Last Update Date | 07/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 495 HIGHLAND BLVD
-----------------------------------------------------
City | COATESVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19320-5822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-384-9500
-----------------------------------------------------
Fax | 610-384-3998
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 495 HIGHLAND BLVD
-----------------------------------------------------
City | COATESVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19320-5822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-384-9500
-----------------------------------------------------
Fax | 610-384-3998
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | MD464081
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------