Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | MD020497E | PA |
NPI | 1053305920 |
---|---|
Provider Name | Dr. Joseph B Bikowski JR. |
First Address | Sewickley, PA 15143 |
Second Address | Sewickley, PA 15143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 12/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C27794 | (02) | |
C27794 | (02) | PA |