Individual
NILESH BAXI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
359 S MOUNTAIN BLVD, SUITE C-2, MOUNTAINTOP, PA 18707
(570) 455-6385
(570) 579-0355
Mailing address
PO BOX 248, MOUNTAINTOP, PA 18707
(570) 455-6385
(570) 579-0355
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD052115L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014653330005
—
PA
Enumeration date
07/05/2006
Last updated
07/08/2007
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