Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 25MA07757200 | NJ |
NPI | 1265422869 |
---|---|
Provider Name | Dr. Shraddha Mittal |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Voorhees, NJ 08043-1548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2005 |
Last Update Date | 13/05/2013 |