Provider Demographics
NPI:1679896492
Name:PARIKH, VIRAJ ASHISH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:VIRAJ
Middle Name:ASHISH
Last Name:PARIKH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1922 STONE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1722
Mailing Address - Country:US
Mailing Address - Phone:610-212-0745
Mailing Address - Fax:
Practice Address - Street 1:1922 STONE RIDGE LN
Practice Address - Street 2:
Practice Address - City:VILLANOVA
Practice Address - State:PA
Practice Address - Zip Code:19085-1722
Practice Address - Country:US
Practice Address - Phone:610-212-0745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA-002979-L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS87941Medicare UPIN