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General NPI Number Information
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NPI Number | 1922611607
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Entity Type | Individual
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Provider Name | SHILPA EMANI
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Gender | Female
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 08/24/2020
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Provider Practice Location Address
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Address Line | 2107B COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1122
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Country | US
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Telephone | 312-274-4526
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Fax |
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Provider Business Mailing Address
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Address Line | 275 S BRYN MAWR AVE APT K32
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City | BRYN MAWR
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State | PA
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Zip | 19010-4248
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Country | US
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Telephone | 848-234-6766
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DS042882
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License Number State | PA
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