Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | MD060203L | PA |
NPI | 1619979333 |
---|---|
Provider Name | Dr. Deborah Ann Gentile |
First Address | Butler, PA 16001-7612 |
Second Address | Butler, PA 16001-7612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 06/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017501400003 | (05) | PA |
2146261 | (05) | OH |
6700525000 | (05) | WV |
830918 | MEDICARE (01) | PA |
H06301 | (02) | PA |