Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP023319 | PA |
NPI | 1013597533 |
---|---|
Provider Name | Eika Maria Barriera-Justiniano |
First Address | Philadelphia, PA 19107-5005 |
Second Address | Philadelphia, PA 19107-4944 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2021 |
Last Update Date | 12/01/2022 |