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Organization

ASHOK J BHARUCHA MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ASHOK J BHARUCHA (MD)
(608) 797-8287
Entity
Organization

Contact information

Practice address
119 S BURROWES ST, SUIE 602, STATE COLLEGE, PA 16801-3894
(608) 797-8287
(814) 690-2151
Mailing address
603 KREAMER AVE, LEWISBURG, PA 17837-6858
(608) 797-8287
(814) 690-2151

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD070573L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
813550001
MEDICARE PTAN
IL
Enumeration date
01/27/2015
Last updated
01/27/2015
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