Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | MD00030067 | WA |
Y | 207U00000X | Nuclear Medicine Specialist | MD445248 | PA |
NPI | 1497840896 |
---|---|
Provider Name | David Abraham Mankoff |
First Address | Philadelphia, PA 19104-4206 |
Second Address | Philadelphia, PA 19104-4206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 05/06/2012 |