Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | MD027910E | PA |
NPI | 1407027725 |
---|---|
Provider Name | Dr. Trusandra Elaine Taylor |
First Address | Philadelphia, PA 19130-1415 |
Second Address | Philadelphia, PA 19122-3008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2008 |
Last Update Date | 02/06/2014 |