Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MD022509E | PA |
NPI | 1104983766 |
---|---|
Provider Name | Dr. Benjamin Gocial |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Philadelphia, PA 19107-4414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 11/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E69160 | (02) | PA |