Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | MD464029 | PA |
NPI | 1134563224 |
---|---|
Provider Name | Crystal Ann Nunez |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2013 |
Last Update Date | 19/08/2019 |