Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | SP025035 | PA |
NPI | 1003575119 |
---|---|
Provider Name | Anita Acharya |
First Address | Bensalem, PA 19020-2339 |
Second Address | Bensalem, PA 19020-2339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2021 |
Last Update Date | 16/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0514 | (05) | PA |