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General NPI Number Information
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NPI Number | 1215094297
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Entity Type | Individual
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Provider Name | AMI DINESH GORADIA MD
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Gender | Female
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 1900 HAMILTON ST UNIT 609
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City | PHILADELPHIA
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State | PA
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Zip | 19130-4502
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Country | US
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Telephone | 267-252-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 HAMILTON ST UNIT 609
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City | PHILADELPHIA
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State | PA
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Zip | 19130-4502
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Country | US
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Telephone | 267-252-3232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MT182650
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License Number State | PA
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