Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD439141 | PA |
NPI | 1013248632 |
---|---|
Provider Name | Chitra Sivasankar |
First Address | Philadelphia, PA 19107-4824 |
Second Address | Philadelphia, PA 19107-4824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2010 |
Last Update Date | 25/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03252155 | (05) | NY |
102498251001 | (05) | PA |