Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | DA028723A | PA |
NPI | 1134218589 |
---|---|
Provider Name | Dr. Robert A. Nassif JR. |
First Address | Mars, PA 16046-2153 |
Second Address | Pittsburgh, PA 15220-3510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 02/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U64292 | (02) | PA |