Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD443098 | PA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD443098 | PA |
NPI | 1134385644 |
---|---|
Provider Name | Mahima Tibrewal |
First Address | Voorhees, NJ 08043-3520 |
Second Address | Easton, PA 18045-5669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 03/02/2022 |