Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 25MA08370600 | NJ |
NPI | 1336311661 |
---|---|
Provider Name | Robert A Mohapatra |
First Address | Marlton, NJ 08053-4197 |
Second Address | Cherry Hill, NJ 08034-2600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2008 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0170038 | (05) | NJ |