Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD439496 | PA |
N | 207VX0000X | Obstetrician | 2006015601 | MO |
NPI | 1437372604 |
---|---|
Provider Name | Dr. Sara Shaw Nicholas |
First Address | New York, NY 10087-2581 |
Second Address | West Chester, PA 19382-4882 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 15/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0293636 | (05) | NJ |
1027138310001 | (05) | PA |