Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD439185 | PA |
NPI | 1083868905 |
---|---|
Provider Name | Brooke Nicole Bosley Bednarski |
First Address | Jeannette, PA 15644-2538 |
Second Address | Greensburg, PA 15601-2820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2008 |
Last Update Date | 06/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102504690 | (05) | PA |