Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | MD402760 | PA |
NPI | 1790722981 |
---|---|
Provider Name | Dr. Debra Jih |
First Address | Philadelphia, PA 19103-6457 |
Second Address | Philadelphia, PA 19107-6187 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 27/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1466044 | PENNSYLVANIA BLUE SHIELD (01) | PA |
2150309000 | INDEPENDENCE BLUE CROSS (01) | PA |
7772455 | AETNA HEALTH]PLANS (01) | PA |