Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | MT205491 | PA |
NPI | 1124319280 |
---|---|
Provider Name | Dr. Sabrina Gmuca |
First Address | Philadelphia, PA 19102-4329 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2011 |
Last Update Date | 20/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
268562 | NY STATE MEDICAL LICENSE (01) | NY |