Basic Information
| Provider Information | |||||||||
| NPI: | 1942654041 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | MALHOTRA | ||||||||
| FirstName: | ASEEM | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2001 HAMILTON STREET | ||||||||
| Address2: | NORTH TOWER, APARTMENT 1829 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152066408 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3400 CIVIC CENTER BLVD | ||||||||
| Address2: | UROLOGY, 3 PCAM, WEST PAVILION | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191045127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156626156 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2016 | ||||||||
| LastUpdateDate: | 08/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | MT210389 | PA | Y | Allopathic & Osteopathic Physicians | Urology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.