Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 35077887G | OH |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD058330L | PA |
NPI | 1013918762 |
---|---|
Provider Name | Dr. Vicenta Candelario Gaspar-Yoo |
First Address | Natrona Heights, PA 15065-1152 |
Second Address | Natrona Heights, PA 15065-1152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 24/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2190114 | (05) | OH |
G86540 | (02) | OH |