Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.129784 | OH |
Y | 2080P0205X | Pediatric Endocrinologist | MD474304 | PA |
NPI | 1053704148 |
---|---|
Provider Name | Padmaja Chilukoti |
First Address | Erie, PA 16501-1758 |
Second Address | Erie, PA 16501-1758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2015 |
Last Update Date | 22/12/2021 |