Provider Demographics
NPI:1902802622
Name:RISHI, FOUZIA (MD)
Entity Type:Individual
Prefix:
First Name:FOUZIA
Middle Name:
Last Name:RISHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 VISTA DR
Mailing Address - Street 2:STE 3
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-2541
Mailing Address - Country:US
Mailing Address - Phone:717-765-6621
Mailing Address - Fax:717-765-6559
Practice Address - Street 1:27 VISTA DR
Practice Address - Street 2:STE 3
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2541
Practice Address - Country:US
Practice Address - Phone:717-765-6621
Practice Address - Fax:717-765-6559
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-059862-L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018075000002OtherMEDICAL ASSISTANCE
G38819Medicare UPIN