Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 25MA09160500 | NJ |
N | 207V00000X | Obstetrician & Gynecologist | MD471825 | PA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD471825 | PA |
NPI | 1063696763 |
---|---|
Provider Name | Dr. Nyarai Chinyani Mushonga |
First Address | York, PA 17402-9001 |
Second Address | Greencastle, PA 17225-1623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2007 |
Last Update Date | 26/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0583588 | (05) | NJ |