Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS018381 | PA |
N | 207QS0010X | Family Doctor - Sports Medicine | OS018381 | PA |
NPI | 1134508658 |
---|---|
Provider Name | Dr. Ilana Zeises |
First Address | Harleysville, PA 19438-0907 |
Second Address | Chalfont, PA 18914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2015 |
Last Update Date | 10/10/2019 |