Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD453190 | PA |
NPI | 1013295856 |
---|---|
Provider Name | Ms. Shivani Dua |
First Address | King Of Prussia, PA 19406-4206 |
Second Address | Pittsburgh, PA 15212-4756 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2011 |
Last Update Date | 20/02/2020 |