Basic Information
| Provider Information | |||||||||
| NPI: | 1346227675 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AYYAGARI | ||||||||
| FirstName: | ARAVINDA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5000 COX RD | ||||||||
| Address2: | |||||||||
| City: | GLEN ALLEN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 230609263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8048224355 | ||||||||
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| Practice Location | |||||||||
| Address1: | 417 BALTIMORE PIKE | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190643810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4844702600 | ||||||||
| FaxNumber: | 6102735520 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2005 | ||||||||
| LastUpdateDate: | 08/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | C10006345 | DE | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | 208D00000X | C10006345 | DE | N | Allopathic & Osteopathic Physicians | General Practice | 208000000X | MD073432L | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.