Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MD033016E | PA |
NPI | 1073528881 |
---|---|
Provider Name | Dr. Susheela Nagaraj |
First Address | Downingtown, PA 19335-3462 |
Second Address | Coatesville, PA 19320-2040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 08/07/2007 |