Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD040489E | PA |
NPI | 1548210024 |
---|---|
Provider Name | Mr. Gazi Abdulhay |
First Address | Upland, PA 19013 |
Second Address | Upland, PA 19013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 17/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011224740004 | (05) | PA |
1701986 | ECFMG (01) | |
5540607 | (05) | NJ |
B42352 | (02) |