Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD458447 | PA |
N | 207RX0202X | Medical Oncology | 103723 | MO |
NPI | 1114943420 |
---|---|
Provider Name | Dr. Gerald Linette |
First Address | Philadelphia, PA 19104-5127 |
Second Address | Saint Louis, MO 63110-1032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 30/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014410183 | (05) | MO |