Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT212033 | PA |
N | 111NI0900X | Internist | MT212033 | PA |
NPI | 1003361205 |
---|---|
Provider Name | Utpal Jha |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-1523 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2016 |
Last Update Date | 11/02/2021 |