Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | MD448009 | PA |
NPI | 1053624056 |
---|---|
Provider Name | Dr. Susan K Yaeger |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103-6202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2010 |
Last Update Date | 04/04/2019 |