Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 055175 | GA |
Y | 207PP0204X | Pediatric Emergency Physician | MD446379 | PA |
N | 2080P0204X | Pediatric Emergency Doctor | N5553 | TX |
NPI | 1104842137 |
---|---|
Provider Name | Subhankar Bandyopadhyay |
First Address | Hershey, PA 17033-2360 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 11/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F91472 | (02) |