Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223X0400X | Orthodontists | 22DI02624200 | NJ |
Y | 1223X0400X | Orthodontists | DS040291 | PA |
NPI | 1043685050 |
---|---|
Provider Name | Cara Conroy Piskai |
First Address | Philadelphia, PA 19103-5862 |
Second Address | Bryn Mawr, PA 19010-3120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2015 |
Last Update Date | 02/12/2015 |