Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | OT021034 | PA |
NPI | 1023502317 |
---|---|
Provider Name | Kutaiba Nazif |
First Address | Allentown, PA 18105-1556 |
Second Address | Allentown, PA 18103-6381 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2018 |
Last Update Date | 01/07/2021 |