Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DS 028196-L | PA |
NPI | 1093739807 |
---|---|
Provider Name | Dr. Ann Kearney Astolfi |
First Address | Bethlehem, PA 18020-8908 |
Second Address | Bethlehem, PA 18020-8908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |