Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD015620E | PA |
N | 111NI0900X | Internist | MD015620E | PA |
Y | 207RX0202X | Medical Oncology | MD015620E | PA |
NPI | 1114947967 |
---|---|
Provider Name | Dr. Emmanuel C. Besa |
First Address | Philadelphia, PA 19106-4404 |
Second Address | Philadelphia, PA 19107-4824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 26/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000755660 | (05) | PA |
9079904 | (05) | NJ |