Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD043286E | PA |
N | 111NI0900X | Internist | MD043286E | PA |
N | 207U00000X | Nuclear Medicine Specialist | MD043286E | PA |
NPI | 1699733022 |
---|---|
Provider Name | Dr. Mark Tulchinsky |
First Address | Hershey, PA 17033-0854 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011799960003 | (05) | PA |
E70727 | (02) |