Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 57.028114 | OH |
Y | 2080P0205X | Pediatric Endocrinologist | MT217792 | PA |
NPI | 1093179657 |
---|---|
Provider Name | Dr. Camilia Kamoun |
First Address | Philadelphia, PA 19103-4870 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2016 |
Last Update Date | 26/06/2019 |