Provider Demographics
NPI:1871722116
Name:RATHINAMANICKAM, HARINI (MD)
Entity type:Individual
Prefix:
First Name:HARINI
Middle Name:
Last Name:RATHINAMANICKAM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6439
Mailing Address - Fax:570-271-6852
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-9800
Practice Address - Country:US
Practice Address - Phone:570-271-6439
Practice Address - Fax:570-271-6852
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAFR5441100207RG0100X
PAMD488106207RG0100X
FLME160111207RT0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology