Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | OS011854 | PA |
NPI | 1053306290 |
---|---|
Provider Name | Carol Anne Dillon |
First Address | Warminster, PA 18974-5206 |
Second Address | Warminster, PA 18974-5206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 03/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1866307 | AETNA HMO (01) | |
2238420000 | KHPE (01) | |
7579493 | AETNA PPO (01) | |
H99560 | (02) |