Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | 046466L | PA |
N | 207NP0225X | Pediatric Dermatologist | MD046466L | PA |
N | 207NS0135X | Procedural Dermatology | MD046466L | PA |
NPI | 1356349377 |
---|---|
Provider Name | Dr. Victoria Ann Cirillo-Hyland |
First Address | Bryn Mawr, PA 19010-1352 |
Second Address | Bryn Mawr, PA 19010-1352 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 04/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F43810 | (02) | PA |