Basic Information
| Provider Information | |||||||||
| NPI: | 1952315012 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BATRA | ||||||||
| FirstName: | ERICH | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | HERSHEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170332360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431455 | ||||||||
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| Practice Location | |||||||||
| Address1: | 941 PARK DR | ||||||||
| Address2: | |||||||||
| City: | PALMYRA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170783445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002431455 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 03/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD065166L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | MD065166L | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 0875484 | 01 | PA | KEYSTONE CAPITAL BC | OTHER | 19887 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 2220197 | 01 | PA | AETNA | OTHER | 001698120 | 05 | PA | MEDICAID | P001772 | 05 | PA | MEDICAID |