Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD429140 | PA |
N | 207VG0400X | Gynecologist | MD429140 | PA |
NPI | 1669419198 |
---|---|
Provider Name | Dr. Radhika Ailawadi |
First Address | East Stroudsburg, PA 18301-3006 |
Second Address | Stroudsburg, PA 18360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 05/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102278820 | (05) | PA |
H85049 | (02) |