Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD455044 | PA |
N | 111NI0900X | Internist | MD455044 | PA |
N | 207RG0300X | Geriatric Medicine | MD455044 | PA |
Y | 207RH0002X | Hospice and Palliative Medicine | MD455044 | PA |
NPI | 1184949406 |
---|---|
Provider Name | Niharika Ganta |
First Address | Philadelphia, PA 19104-4238 |
Second Address | Philadelphia, PA 19104-4238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 21/03/2019 |