Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD053975L | PA |
N | 111NI0900X | Internist | MD053975L | PA |
Y | 207RI0200X | Infectious Disease | MD053957L | PA |
NPI | 1033132352 |
---|---|
Provider Name | Dr. Phyllis R. Flomenberg |
First Address | Philadelphia, PA 19107-4316 |
Second Address | Philadelphia, PA 19107-4316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 12/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001675985 | (05) | PA |
7505906 | (05) | NJ |