Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 255190 | NY |
Y | 2080P0205X | Pediatric Endocrinologist | 25MA0860330 | NJ |
NPI | 1396060315 |
---|---|
Provider Name | Mariam Gangat |
First Address | Philadelphia, PA 19182-9642 |
Second Address | New Brunswick, NJ 08901-1935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2010 |
Last Update Date | 23/07/2021 |