Individual
POUYA BANDEGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4870
(215) 955-6000
Mailing address
943 LOMBARD ST, PHILADELPHIA, PA 19147-1239
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MT233130
PA
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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