Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | DS024531L | PA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | DS024531L | PA |
NPI | 1467428276 |
---|---|
Provider Name | Dr. Timothy Joseph Armanini |
First Address | Erie, PA 16506-4932 |
Second Address | Erie, PA 16506-4932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DS024531L | STATE LICENSE (01) | PA |
T72023 | (02) |