Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC003243L | PA |
Y | 222Z00000X | Podiatrist | SC003243L | PA |
NPI | 1023210705 |
---|---|
Provider Name | Dr. Raffi H Kadian |
First Address | Albrightsville, PA 18210-0163 |
Second Address | Albrightsville, PA 18210-0163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011322000011 | (05) | PA |
1001055 | KEYSTONE MERCY HEALTH PLA (01) | PA |
13585 | HEALTH PARTNERS (01) | PA |
T30766 | (02) |