Basic Information
| Provider Information | |||||||||
| NPI: | 1942684485 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHRESTHA | ||||||||
| FirstName: | DIKSHA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 702 DARLEY GREEN DR | ||||||||
| Address2: | |||||||||
| City: | CLAYMONT | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197033120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3473482069 | ||||||||
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| Practice Location | |||||||||
| Address1: | 833 CHESTNUT ST STE 1210 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159552074 | ||||||||
| FaxNumber: | 2158610408 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2015 | ||||||||
| LastUpdateDate: | 07/11/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2080N0001X | MT216236 | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
No ID Information.