Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD057762L | PA |
NPI | 1194911909 |
---|---|
Provider Name | Dr. Angela A D'urso |
First Address | Morgantown, PA 19543-8849 |
Second Address | Morgantown, PA 19543-8849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2007 |
Last Update Date | 15/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8013209 | (05) | MN |
H01944 | (02) | MN |