Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | TLH50838 | NJ |
NPI | 1003876186 |
---|---|
Provider Name | Dr. Pankaja Achar |
First Address | Edison, NJ 08820 |
Second Address | Newark, NJ 07108-2809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 12/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6459706 | (05) | NJ |
E01413 | (02) |