Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 026719E | PA |
NPI | 1003816612 |
---|---|
Provider Name | Dr. Eugenio A. Sybing |
First Address | Grove City, PA 16127-4604 |
Second Address | Grove City, PA 16127-4604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0851317 | (05) | PA |
B34077 | (02) | PA |