Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | DC008745 | PA |
NPI | 1477598647 |
---|---|
Provider Name | Dr. Robert Scott Livingston |
First Address | Trenton, NJ 08690-1946 |
Second Address | Phoenixville, PA 19460-1808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 08/07/2007 |