Individual
MARIKO NAKANISHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA, PHILADELPHIA, PA 19104-4319
(215) 590-1000
Mailing address
100 N 20TH ST, SUITE 301, PHILADELPHIA, PA 19103-1443
(215) 567-2422
(215) 561-0959
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD429513
PA
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
MD429513
PA
Other
Enumeration date
05/25/2007
Last updated
04/05/2012
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