Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.093243 | OH |
Y | 2080P0205X | Pediatric Endocrinologist | MD466667 | PA |
NPI | 1245408152 |
---|---|
Provider Name | Somashekhar Rachaiah |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-2071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 28/08/2020 |