Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | P2353 | TX |
N | 111NI0900X | Internist | P2353 | TX |
Y | 207RH0002X | Hospice and Palliative Medicine | 006404 | AZ |
NPI | 1225397896 |
---|---|
Provider Name | Catherine C Romano Delange |
First Address | Flagstaff, AZ 86001-3118 |
Second Address | Flagstaff, AZ 86001-3118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2012 |
Last Update Date | 14/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
927004 | (05) | AZ |