Individual
AVANI DALAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3098
(215) 456-7890
Mailing address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3098
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A178810
CA
207Q00000X
Family Medicine Physician
Primary
MD476262
PA
207Q00000X
Family Medicine Physician
MT217491
PA
Other
Enumeration date
04/19/2019
Last updated
04/30/2024
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