Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A98759 | CA |
N | 208000000X | Pediatrician | MD433789 | PA |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD433789 | PA |
NPI | 1114103199 |
---|---|
Provider Name | Nadir Yehya |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2008 |
Last Update Date | 17/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1025953710001 | (05) | PA |
222095EMD | MEDICARE PTAN (01) | PA |