Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | MD037079-E | PA |
NPI | 1720006018 |
---|---|
Provider Name | Denise K. Shusterman |
First Address | Richboro, PA 18954-2000 |
Second Address | Allentown, PA 18104-9147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 25/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F04337 | (02) | PA |