Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 25MA07896700 | NJ |
Y | 2080P0214X | Pediatric Pulmonologist | MD044256E | PA |
NPI | 1407890726 |
---|---|
Provider Name | Dr. Laurie Varlotta |
First Address | Philadelphia, PA 19134-1011 |
Second Address | Philadelphia, PA 19134-1011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 17/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012822900001 | (05) | PA |
F26202 | (02) | PA |