Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 151429 | CA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD467593 | PA |
NPI | 1154717619 |
---|---|
Provider Name | Nicki Vithalani |
First Address | Danville, PA 17822-4903 |
Second Address | Lewistown, PA 17044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2015 |
Last Update Date | 30/08/2020 |