Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD454718 | PA |
N | 2080A0000X | Adolescent Medicine | 036129157 | IL |
NPI | 1053669176 |
---|---|
Provider Name | Trupti Pandit |
First Address | Rockland, DE 19732-0191 |
Second Address | Vineland, NJ 08360-7059 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2012 |
Last Update Date | 21/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103004777 | (05) | PA |