Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | MD434466 | PA |
NPI | 1386697118 |
---|---|
Provider Name | Dr. Alyssa R Terk |
First Address | Merion Station, PA 19066-1019 |
Second Address | Philadelphia, PA 19134-1043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 02/08/2011 |