Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223E0200X | Endodontist | 22DI02590900 | NJ |
Y | 1223E0200X | Endodontist | DS038901 | PA |
NPI | 1881962108 |
---|---|
Provider Name | Dr. Arnav R Mistry |
First Address | Bensalem, PA 19020-7834 |
Second Address | Ship Bottom, NJ 08008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2011 |
Last Update Date | 07/03/2019 |