Basic Information
| Provider Information | |||||||||
| NPI: | 1538229075 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOROKHINE | ||||||||
| FirstName: | IGOR | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1553 CHESTER PIKE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CRUM LYNNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190221022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104997180 | ||||||||
| FaxNumber: | 6108760859 | ||||||||
| Practice Location | |||||||||
| Address1: | 1553 CHESTER PIKE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CRUM LYNNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190221022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104997180 | ||||||||
| FaxNumber: | 6108760859 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2006 | ||||||||
| LastUpdateDate: | 10/02/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD430069 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207RG0300X | MD430069 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.