Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT001545E | PA |
NPI | 1306200555 |
---|---|
Provider Name | Dr. Janet E. Roberto |
First Address | Willow Grove, PA 19090-1109 |
Second Address | Willow Grove, PA 19090-1109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2016 |
Last Update Date | 13/04/2016 |