Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD428587 | PA |
Y | 208600000X | Surgeon | MD428587 | PA |
N | 2086X0206X | Surgical Oncologist | 045685 | CT |
N | 2086X0206X | Surgical Oncologist | MD428587 | PA |
NPI | 1083875983 |
---|---|
Provider Name | Dr. Carla J. Christy |
First Address | Harrisburg, PA 17104-1677 |
Second Address | Harrisburg, PA 17109-5317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2008 |
Last Update Date | 06/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102319412 0001 | (05) | PA |