Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD430331 | PA |
NPI | 1457568354 |
---|---|
Provider Name | Dr. Maria J Bertucci |
First Address | Newtown, PA 18940-1873 |
Second Address | Langhorne, PA 19047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 14/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1019786540001 | (05) | PA |
I73794 | (02) | PA |