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General NPI Number Information
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NPI Number | 1902806458
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Entity Type | Organization
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Legal Business Name | NORTHERN VALLEY PRIMARY CARE,P.C
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Dates
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Enumeration Date | 07/27/2005
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 44 W 21ST ST SUITE 101
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City | NORTHAMPTON
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State | PA
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Zip | 18067-1221
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Country | US
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Telephone | 610-261-0999
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Fax | 610-261-2187
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Provider Business Mailing Address
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Address Line | 44 W 21ST ST SUITE 101
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City | NORTHAMPTON
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State | PA
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Zip | 18067-1221
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Country | US
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Telephone | 610-261-0999
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Fax | 610-261-2187
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | YASMEEN SORATHIA
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Credential |
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Telephone | 610-261-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS013857
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 062722-L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA051873
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD052173-L
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA053534
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 044704-L
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License Number State | PA
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