Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 261160 | MA |
Y | 207VE0102X | Reproductive Endocrinologist | MD464896 | PA |
NPI | 1154647956 |
---|---|
Provider Name | Dr. Allison Lange |
First Address | King Of Prussia, PA 19406-1329 |
Second Address | King Of Prussia, PA 19406-1438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2010 |
Last Update Date | 02/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
23-2386239 | TAX ID (01) | PA |