Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD429761 | PA |
Y | 2080P0201X | Pediatric Allergist | MD429761 | PA |
NPI | 1609993609 |
---|---|
Provider Name | Antonella Cianferoni |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Philadelphia, PA 19104-3365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 12/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1019987820001 | (05) | PA |