Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | MD432057 | PA |
NPI | 1184869414 |
---|---|
Provider Name | Nandhini Veeraraghavan |
First Address | Bethlehem, PA 18017-4204 |
Second Address | Bethlehem, PA 18017-4204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2008 |
Last Update Date | 08/07/2015 |