Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | C10008152 | DE |
N | 2080P0204X | Pediatric Emergency Doctor | C10008152 | DE |
NPI | 1003976101 |
---|---|
Provider Name | Dr. Alexandra A. Taylor |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 03/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0113379 | (05) | NJ |
101765637 | (05) | PA |
H54184 | (02) |