Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MT217710 | PA |
Y | 2084N0402X | Child Neurologist | MT217710 | PA |
NPI | 1407414790 |
---|---|
Provider Name | Dr. Laura Mcgarry |
First Address | Philadelphia, PA 19104-4319 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2019 |
Last Update Date | 29/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MT217710 | MEDICAL LICENSE (01) | PA |