Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | MD060192L | PA |
Y | 208000000X | Pediatrician | MD060192L | PA |
NPI | 1407890163 |
---|---|
Provider Name | Dr. Lara Rita Ferri |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Philadelphia, PA 19134-1095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 22/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017442960004 | (05) | PA |
G90002 | (02) | PA |