Provider Demographics
NPI:1396057220
Name:DUTTA, ABHISHEK (MD)
Entity type:Individual
Prefix:
First Name:ABHISHEK
Middle Name:
Last Name:DUTTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:145 GROWDEN LDG
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-1263
Mailing Address - Country:US
Mailing Address - Phone:718-650-9884
Mailing Address - Fax:
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD STE 320
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1235
Practice Address - Country:US
Practice Address - Phone:215-750-7818
Practice Address - Fax:215-752-0436
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD479150207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCD281AMedicare PIN