Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | OS-005122L | PA |
NPI | 1134221005 |
---|---|
Provider Name | Dr. Barbara Mirth-Jacobelli |
First Address | Yardley, PA 19067-1441 |
Second Address | Newtown, PA 18940-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 19/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B42226 | (02) | PA |