Individual
AUDREY HAN NGOC LE MAHAJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3400 SPRUCE ST STE E, PHILADELPHIA, PA 19104-4223
(267) 847-9559
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4741
(401) 444-4445
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD471772
PA
207RI0200X
Infectious Disease Physician
MT216168
PA
Other
Enumeration date
05/15/2015
Last updated
09/08/2020
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