Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MT209191 | PA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 25MA11278600 | NJ |
NPI | 1144600271 |
---|---|
Provider Name | Dayna Phillips |
First Address | Philadelphia, PA 19140-5103 |
Second Address | Emerson, NJ 07630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2015 |
Last Update Date | 27/12/2021 |