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General NPI Number Information
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NPI Number | 1245999838
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Entity Type | Individual
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Provider Name | RAJBINDER RANDHAWA CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/11/2021
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Last Update Date | 12/11/2021
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Provider Practice Location Address
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Address Line | 6787 MARKET ST STE 101
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City | UPPER DARBY
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State | PA
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Zip | 19082-1848
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Country | US
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Telephone | 610-352-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 29 MARIAN CT
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City | MILLBOURNE
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State | PA
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Zip | 19082-1806
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Country | US
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Telephone | 610-937-1155
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP024150
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License Number State | PA
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