Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | OS013147 | PA |
NPI | 1013095413 |
---|---|
Provider Name | Dr. Thomas S Dardarian |
First Address | New York, NY 10087-2581 |
Second Address | Bryn Mawr, PA 19010-1451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 28/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
093537TGW | MEDICARE PTAN (01) | PA |
101349730 | (05) | PA |
I37725 | (02) | PA |