Basic Information
Provider Information
NPI: 1063808921
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PASRICHA
FirstName: VENU
MiddleName:  
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Mailing Information
Address1: PO BOX 829641
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191829641
CountryCode: US
TelephoneNumber: 2673705296
FaxNumber: 2152303725
Practice Location
Address1: 595 W STATE ST
Address2:  
City: DOYLESTOWN
State: PA
PostalCode: 189012554
CountryCode: US
TelephoneNumber: 2153452885
FaxNumber: 2153452552
Other Information
ProviderEnumerationDate: 04/07/2015
LastUpdateDate: 06/09/2022
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate: 06/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD464318PAN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XMD464318PAY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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