Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC007118 | PA |
NPI | 1023635646 |
---|---|
Provider Name | Sushila Lynn Kabadi |
First Address | Harrisburg, PA 17105-8700 |
Second Address | Harrisburg, PA 17101-2010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2020 |
Last Update Date | 30/06/2020 |