Basic Information
Provider Information
NPI: 1598710444
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARWAHA
FirstName: RAHUL
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 W 10TH ST
Address2:  
City: MARCUS HOOK
State: PA
PostalCode: 190614513
CountryCode: US
TelephoneNumber: 6108598850
FaxNumber: 6108597876
Practice Location
Address1: 4709 KIRKWOOD HWY
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198085007
CountryCode: US
TelephoneNumber: 3029989880
FaxNumber: 3029987498
Other Information
ProviderEnumerationDate: 05/22/2006
LastUpdateDate: 02/18/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XJ1-0001970DEY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
P0035963401DEMEDICARE RAILROADOTHER
159871044405DE MEDICAID
374832200001DEIBCOTHER
00010091901DEDPCIOTHER


Home