Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD472215 | PA |
NPI | 1093261810 |
---|---|
Provider Name | Dr. Divya Sistla |
First Address | Mc Kees Rocks, PA 15136-4103 |
Second Address | Pittsburgh, PA 15213-3403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2016 |
Last Update Date | 09/03/2021 |