Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD047337 | DC |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 0101269635 | VA |
NPI | 1780039404 |
---|---|
Provider Name | Pallavi Doddakashi |
First Address | Neptune, NJ 07753-2645 |
Second Address | Hackensack, NJ 07601-1962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2016 |
Last Update Date | 02/12/2021 |