Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC002793L | PA |
Y | 222Z00000X | Podiatrist | SC002793L | PA |
NPI | 1053490458 |
---|---|
Provider Name | Dr. Joan Theresa Walsh-Philip |
First Address | Washington Crossing, PA 18977-1338 |
Second Address | Washington Crossing, PA 18977-1338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2006 |
Last Update Date | 09/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
145426 | PABS (01) | PA |
T29583 | (02) | PA |