Basic Information
Provider Information
NPI: 1710327549
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AMIN
FirstName: ANKIT
MiddleName: C
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 245 N 15TH ST
Address2: MAIL STOP 427
City: PHILADELPHIA
State: PA
PostalCode: 191021101
CountryCode: US
TelephoneNumber: 2157627698
FaxNumber: 2157627765
Practice Location
Address1: 230 N BROAD ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191021121
CountryCode: US
TelephoneNumber: 2157627698
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/25/2013
LastUpdateDate: 05/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMT205176PAN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X0101260677VAN Allopathic & Osteopathic PhysiciansHospitalist 
208M00000X2017-02376NCN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X2017-02376NCY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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