Individual
PRAFULCHADRA K TILVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 N 11TH ST, SUNBURY, PA 17801-1611
(570) 286-3470
(570) 286-3397
Mailing address
THREE GATEWAY CENTER, 20TH FLOOR, 401 LIBERTY AVENUE, SUITE 2000, PITTSBURGH, PA 15222
(412) 223-2272
(412) 281-6320
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD019302E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009545200001
—
PA
05
—
0009545200004
—
PA
05
—
0009545200008
—
PA
01
—
0104798
BLUE SHIELD
PA
01
—
P00427548
RAILROAD MEDICARE
PA
Enumeration date
11/21/2005
Last updated
10/27/2008
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