Individual
ANANYA DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
160 E ERIE AVE, PHILADELPHIA, PA 19134-1011
(919) 413-1907
Mailing address
160 E ERIE AVE, PHILADELPHIA, PA 19134-1011
(919) 413-1907
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
183395
TN
163W00000X
Registered Nurse
670377
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
SP016656
PA
Other
Enumeration date
07/14/2015
Last updated
10/17/2016
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