Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD420668 | PA |
N | 207YS0123X | Facial Plastic Surgeon | MD420668 | PA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | MD420668 | PA |
NPI | 1154358117 |
---|---|
Provider Name | Dr. Ryan Heffelfinger |
First Address | Philadelphia, PA 19107-4216 |
Second Address | Philadelphia, PA 19107-4216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 24/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0106330 | (05) | NJ |
101661900 | (05) | PA |
I44657 | (02) |