Basic Information
Provider Information
NPI: 1003014473
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARAK
FirstName: RAKESH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 200068
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152510068
CountryCode: US
TelephoneNumber: 8882761003
FaxNumber: 7173902455
Practice Location
Address1: 2500 BERNVILLE RD
Address2:  
City: READING
State: PA
PostalCode: 196059453
CountryCode: US
TelephoneNumber: 6103730165
FaxNumber: 6103735251
Other Information
ProviderEnumerationDate: 07/06/2007
LastUpdateDate: 07/03/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085N0904XC1-0013159DEN Allopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
2085R0202XMD439457PAY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XC1-0013159DEN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
421470401 MEDICARE IDOTHER


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