Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD433881 | PA |
NPI | 1003024365 |
---|---|
Provider Name | Dr. Rika N Omalley |
First Address | Philadelphia, PA 19107-5002 |
Second Address | Philadelphia, PA 19107-5002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 06/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0167452 | (05) | NJ |
102187663 | (05) | PA |