Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD070373L | PA |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 47100 | TX |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | LT15264 | ND |
NPI | 1447215884 |
---|---|
Provider Name | Dr. Yolanda Denise Heman-Ackah |
First Address | League City, TX 77573 |
Second Address | Bala Cynwyd, PA 19004-3213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 28/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001809078 | (05) | PA |
H21018 | (02) | PA |