Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 45177 | CO |
NPI | 1164573077 |
---|---|
Provider Name | Dr. Bernadette A Albanese |
First Address | Colorado Springs, CO 80910-3123 |
Second Address | Colorado Springs, CO 80910-3123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E54065 | (02) | NM |