Doctor Name: | RACHITA BANSAL |
NPI Number: | 1669762803 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | MD452329 |
Business Practice Address: | 201 Roosevelt Ave Selinsgrove, PA - 17870 |
Business Phone Number: | 5703740151 |
Business Fax Number: | |
Mailing Address: | 201 Roosevelt Ave, SELINSGROVE |
State: | PA |
Postal Code: | 17870 |
Phone Number: | 5705045904 |
Fax Number: | |
NPI Enumeration Date: | 04/08/2011 |
NPI Last Update Date: | 09/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD452329 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |