Provider Demographics
NPI:1942869680
Name:UPADHYAY, NAMAN ASHVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:NAMAN
Middle Name:ASHVIN
Last Name:UPADHYAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 VINE ST APT 902
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1737
Mailing Address - Country:US
Mailing Address - Phone:267-432-0316
Mailing Address - Fax:
Practice Address - Street 1:833 CHESTNUT ST STE 220
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4405
Practice Address - Country:US
Practice Address - Phone:215-955-8465
Practice Address - Fax:215-955-2516
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMT218593390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program