Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD435625 | PA |
N | 2080P0201X | Pediatric Allergist | 036114217 | IL |
NPI | 1467502401 |
---|---|
Provider Name | Anjana Khuntia |
First Address | Blue Bell, PA 19422-2324 |
Second Address | Blue Bell, PA 19422-2324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 03/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036114217 | (05) | IL |