Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | OS010605L | PA |
NPI | 1073547048 |
---|---|
Provider Name | Adele Marie Guernica |
First Address | Collegeville, PA 19426-3600 |
Second Address | Collegeville, PA 19426-3600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 08/07/2007 |