Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | MD054778L | PA |
NPI | 1366424525 |
---|---|
Provider Name | Dr. Suneeta Madan-Khetarpal |
First Address | Pittsburgh, PA 15238-1135 |
Second Address | Pittsburgh, PA 15224-1529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 27/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001746844 | (05) | PA |
BM5378838 | DEA NUMBER (01) | PA |
F25739 | (02) | PA |
MD054778L | MEDICAL LICENSE NUMBER (01) | PA |