Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD425302 | PA |
N | 2080N0001X | Neonatal-Perinatal Doctor | MD425302 | PA |
NPI | 1013910355 |
---|---|
Provider Name | Dr. Pramath Nath |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Doylestown, PA 18901-2554 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 17/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101165877 | (05) | PA |
H28562 | (02) | PA |