Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | MD065674L | PA |
NPI | 1982670808 |
---|---|
Provider Name | Azra M Sehic |
First Address | Kingston, PA 18704-5624 |
Second Address | Kingston, PA 18704-5624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1708262 | (05) | PA |
G27370 | (02) | PA |