Basic Information
Provider Information
NPI: 1699087098
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARIHAR
FirstName: DIVYA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1110 QUINCY AVE APT 4K
Address2:  
City: DUNMORE
State: PA
PostalCode: 185101160
CountryCode: US
TelephoneNumber: 5709032741
FaxNumber:  
Practice Location
Address1: 233 2ND AVE S
Address2:  
City: KENT
State: WA
PostalCode: 980325852
CountryCode: US
TelephoneNumber: 2064366380
FaxNumber: 2064366368
Other Information
ProviderEnumerationDate: 07/14/2010
LastUpdateDate: 11/20/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD60413229WAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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