Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT184458 | PA |
N | 111NI0900X | Internist | MT184458 | PA |
N | 207RH0000X | Hematologist | MD433156 | PA |
Y | 207RX0202X | Medical Oncology | 073112 | GA |
NPI | 1326101718 |
---|---|
Provider Name | Keerthi Gogineni |
First Address | Philadelphia, PA 19104-4206 |
Second Address | Philadelphia, PA 19104-4206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 27/01/2021 |