Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD465647 | PA |
NPI | 1043624281 |
---|---|
Provider Name | Ashley De Padua |
First Address | Bethlehem, PA 18018-2256 |
Second Address | Bethlehem, PA 18018-2256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2014 |
Last Update Date | 17/09/2018 |