Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 30546 | AZ |
NPI | 1295704229 |
---|---|
Provider Name | Dr. Nalini Sridhar Bhalla |
First Address | Phoenix, AZ 85012-1839 |
Second Address | Phoenix, AZ 85012-1839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 17/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
764648 | (05) | AZ |
H82956 | (02) |