Basic Information
Provider Information
NPI: 1811332406
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIRI
FirstName: ANSHU
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2450 W HUNTING PARK AVE
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191291302
CountryCode: US
TelephoneNumber: 2157282500
FaxNumber: 2157283639
Practice Location
Address1: 333 COTTMAN AVE
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191112497
CountryCode: US
TelephoneNumber: 2157282500
FaxNumber: 2157283639
Other Information
ProviderEnumerationDate: 05/08/2013
LastUpdateDate: 09/06/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XMD468586PAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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