Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MA08479600 | NJ |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD446305 | PA |
NPI | 1346236536 |
---|---|
Provider Name | Dr. Carol A. Glowacki |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Philadelphia, PA 19140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2005 |
Last Update Date | 21/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G56384 | (02) | |
G56384 | (02) | MA |