Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MT206230 | PA |
NPI | 1104233915 |
---|---|
Provider Name | Dr. Vijay Palvia |
First Address | Bethlehem, PA 18015-1000 |
Second Address | Bethlehem, PA 18015-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2014 |
Last Update Date | 14/07/2014 |