Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | MT198409 | PA |
NPI | 1255632402 |
---|---|
Provider Name | Hitesh Garg |
First Address | Philadelphia, PA 19178-0001 |
Second Address | Philadelphia, PA 19140-4160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2010 |
Last Update Date | 04/11/2010 |