Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OEG003037 | PA |
NPI | 1013397710 |
---|---|
Provider Name | Angela Tempesta |
First Address | Philadelphia, PA 19123-1660 |
Second Address | Philadelphia, PA 19123-1660 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2015 |
Last Update Date | 08/06/2015 |