Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 25MA08176700 | NJ |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | MD428738 | PA |
Y | 2081P2900X | Pain Medicine | MD428738 | PA |
NPI | 1386665636 |
---|---|
Provider Name | Madhuri Anil Dholakia |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Philadelphia, PA 19107-4216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 10/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1941773 | CIGNA (01) | |
2745732000 | IBC PA (01) | PA |
2817992000 | IBC NJ (01) | NJ |
7353868 | AETNA (01) | |
I57819 | (02) |