Basic Information
Provider Information
NPI: 1407512247
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAREKH
FirstName: PALAK
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 41 UNIVERSITY DR STE 300
Address2:  
City: NEWTOWN
State: PA
PostalCode: 189401873
CountryCode: US
TelephoneNumber: 2157105522
FaxNumber: 2157105181
Practice Location
Address1: 1203 LANGHORNE NEWTOWN RD STE 225
Address2:  
City: LANGHORNE
State: PA
PostalCode: 190471237
CountryCode: US
TelephoneNumber: 2157106613
FaxNumber: 2157106614
Other Information
ProviderEnumerationDate: 11/16/2021
LastUpdateDate: 11/16/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/16/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XSP023759PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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