Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD474393 | PA |
NPI | 1023564739 |
---|---|
Provider Name | Rachana Mundada |
First Address | Berwyn, PA 19312-3805 |
Second Address | Berwyn, PA 19312-3805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2016 |
Last Update Date | 21/09/2021 |