Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 48918 | AZ |
Y | 2080P0205X | Pediatric Endocrinologist | 48918 | AZ |
NPI | 1215193479 |
---|---|
Provider Name | Dr. Reeti Chawla |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Phoenix, AZ 85016-7710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 28/05/2019 |