Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC006545L | PA |
NPI | 1245326560 |
---|---|
Provider Name | Dr. Robert John Nyahay |
First Address | Spring City, PA 19475-1838 |
Second Address | Philadelphia, PA 19144-2704 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000906921 | BS/BS PROVIDER NUMBER (01) | PA |