Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 042-0014765 | VT |
N | 111NI0900X | Internist | 042-0014765 | VT |
NPI | 1003234394 |
---|---|
Provider Name | Nadia Ghallab |
First Address | Morristown, NJ 07960-6136 |
Second Address | Burlington, VT 05401-1473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 04/09/2020 |