Basic Information
Provider Information
NPI: 1881620516
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARIKH
FirstName: PRATIBHA
MiddleName: H
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 832 MCKINLEY AVE NW
Address2:  
City: CANTON
State: OH
PostalCode: 447032463
CountryCode: US
TelephoneNumber: 3304559407
FaxNumber: 3304558706
Practice Location
Address1: 832 MCKINLEY AVE NW
Address2:  
City: CANTON
State: OH
PostalCode: 447032463
CountryCode: US
TelephoneNumber: 3304559407
FaxNumber: 3304558706
Other Information
ProviderEnumerationDate: 06/24/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X35044365OHY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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