Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD439642 | PA |
Y | 2080P0202X | Pediatric Cardiologist | MD436431 | PA |
NPI | 1013175249 |
---|---|
Provider Name | Dr. Jennifer Elizabeth Tingo |
First Address | Bronx, NY 10463-1748 |
Second Address | Philadelphia, PA 19134-1043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2008 |
Last Update Date | 30/11/2015 |