Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | MD447355 | PA |
NPI | 1225037591 |
---|---|
Provider Name | Dr. Tibisay I Villalobos |
First Address | Allentown, PA 18103-6229 |
Second Address | Allentown, PA 18103-6229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 17/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1027656310001 | (05) | PA |