Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MT196006 | PA |
NPI | 1003043928 |
---|---|
Provider Name | Dr. Suprina Dorai |
First Address | Bethlehem, PA 18017-7300 |
Second Address | Bethlehem, PA 18017-7300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 24/06/2010 |