Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 34841 | AZ |
Y | 2080A0000X | Adolescent Medicine | 34841 | AZ |
NPI | 1174585715 |
---|---|
Provider Name | Dr. Karen I Gerber-Vecsey |
First Address | Phoenix, AZ 85020-4492 |
Second Address | Phoenix, AZ 85020-4492 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 16/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
029785 | (05) | AZ |
I50109 | (02) |