Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | MD-066991L | PA |
NPI | 1013967934 |
---|---|
Provider Name | Dr. Nandini Madan |
First Address | Philadelphia, PA 19134 |
Second Address | Philadelphia, PA 19134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018129680005 | (05) | PA |
H22361 | (02) | PA |